COVID-19 に対する院内 PCR 検査業務の構築と現状

Abstract

2020 年 2 月より新型コロナウイルス感染症の市中感染が認められたため，当院でも感染者の受け入れを開始した．COVID-19 に対する検査は当初，外部へ委託していたが，検体の提出から結果報告まで数日かかることは感染者の同定・隔離の遅延や感 染拡大につながる恐れがあり，問題となった．そこで迅速な結果報告のために院内の SARS-CoV-2 核酸増幅検査（ PCR 検査） 体制が必要となった．2020 年 8 月には SARS-CoV-2 核酸増幅装置（ PCR 検査機器）を 2 台導入して院内実施 PCR 検査を開始 した．しかし検体前処理や機器測定に数時間を要したため更なる結果報告の短縮が求められた．そこで検体前処理がなく約 1 時 間で結果報告が可能な迅速 PCR 検査機器を導入・運用を開始した．さらに 24 時間体制ですべての COVID-19 に対する検査が 院内で対応可能となった．この検査体制の構築に寄与した背景には病院の方針に沿った適切な機器導入や検査科スタッフの理 解と協力による柔軟な人員配置，適切な運用方法の確立が挙げられる．

With the spread of community-acquired COVID-19 infection, an increasing number of patients with infectious diseases came to our hospital. In the beginning, the tests for COVID-19 were outsourced. However, the problem was the extended number of days before return of results after submission of specimen. This caused a delay in the identification and quarantine of infected pa tients and increased the possibility of spread of infection. A polymerase chain reaction (PCR) system to test for the SARS-CoV-2 nucleotide within the hospital was considered necessary to speed up the results. In August 2020, two SARS-Cov-2 nucleotide PCR instruments were introduced and the in-hospital PCR testing was started. However, this system required pre-treatment and took several hours. Then, a faster PCR system that gave results within an hour and did not require pre-treatment was introduced. A 24-hour testing system was constructed to enable in-hospital testing for COVIF-19. The application of adequate hospital manage ment strategy to introduce the most appropriate instrument and the instruction of flexible staffing with the understanding and co operation of the testing staff were factors underlying the successful construction of this testing system.