目的 快速查明2021年8月芜湖市某社区卫生服务中心医务人员咽拭子标本SARS-CoV-2核酸阳性原因,提升COVID-19精准防控能力。方法 应用实时荧光RT-PCR技术,对某社区卫生服务中心医务人员10∶1咽拭子混采管标本(某第三方检测机构SARS-CoV-2核酸初筛阳性)及重新采集的咽拭子单采管标本进行SARS-CoV-2核酸复核检测,核酸阳性标本进行SARS-CoV-2 D614G突变位点检测。随后采集该社区卫生服务中心外环境涂抹样进行SARS-CoV-2核酸污染状况评估检测。结果 3份10∶1咽拭子混采管标本中2份核酸双靶标(ORF1ab+N)阳性,35份医务人员和医学实习生咽拭子单采管标本核酸双靶标阴性。混采管阳性标本未发生SARS-CoV-2 D614G位点变异,推断来源于SARS-CoV-2野生株(疫苗株)。12份外环境标本中3份单靶标阳性,其中1份ORF1ab基因阳性,来源于COVID-19疫苗接种人员工作服;2份N基因阳性,来源于COVID-19疫苗接种室键盘和普通疫苗接种室键盘鼠标。结论 某社区卫生服务中心医务人员咽拭子混采管标本SARS-CoV-2核酸阳性是由COVID-19疫苗污染导致。

Objective To quickly find out the cause of SARS-CoV-2 nucleic acid positive in pharyngeal swab samples of medical staff in a community health service center in Wuhu in August 2021,and improve the precision prevention and control ability of COVID-19. Methods Using real-time fluorescent RT-PCR technology,10:1 pharyngeal swab mixed tube samples (SARS-CoV-2 nucleic acid screening positive by a third-party testing organization) and recollected pharyngeal swab single tube samples from a community health service center were rechecked for SARS-CoV-2 nucleic acid,and SARS-CoV-2 D614G mutation sites were detected in nucleic acid positive samples.Then,smear samples from the environment outside the community health service center were collected for SARS-CoV-2 nucleic acid pollution assessment and detection. Results Two of the three 10:1 pharyngeal swab mixed collection tube specimens were positive for nucleic acid double target (ORF1ab+N),and 35 pharyngeal swab single collection tube specimens of medical staff and medical interns were negative for nucleic acid double target.There was no variation of SARS-CoV-2 D614G locus in the positive samples of mixed collection tubes,which was inferred to be from the wild strain of SARS-CoV-2 (vaccine strain).Among the 12 environmental samples,3 were single target positive,of which 1 was ORF1ab gene positive,which came from the work clothes of COVID-19 vaccinators;Two N gene positive samples came from COVID-19 Vaccination Room keyboard and ordinary vaccination room keyboard and mouse. Conclusion The SARS-CoV-2 nucleic acid positive of pharyngeal swab mixed collection tube samples of medical staff in a community health service center was caused by COVID-19 vaccine contamination.