tetano
Editor, Senior Moderator
Infect Control Hosp Epidemiol
. 2024 Jan 4:1-9.
doi: 10.1017/ice.2023.172. Online ahead of print. A severe acute respiratory coronavirus virus 2 (SARS-CoV-2) nosocomial cluster with inter-facility spread: Lessons learned
Aurora E Pop-Vicas[SUP] 1 [/SUP], Laura Anderson[SUP] 2 [/SUP], Gabrielle Hatas[SUP] 2 [/SUP], Linda Stevens[SUP] 3 [/SUP], Ashley Buys[SUP] 4 [/SUP], David O'Connor[SUP] 5 [/SUP], Nancy Wilson[SUP] 5 [/SUP], Kasen Riemersma[SUP] 5 [/SUP], Luis A Haddock Soto[SUP] 5 [/SUP], Abby Richardson[SUP] 6 [/SUP], Christine Clemens[SUP] 6 [/SUP], Jennylynde Packham[SUP] 6 [/SUP], Daniel Shirley[SUP] 1 [/SUP], Nasia Safdar[SUP] 1 7 [/SUP]
Affiliations
Background: Despite infection control guidance, sporadic nosocomial coronavirus disease 2019 (COVID-19) outbreaks occur. We describe a complex severe acute respiratory coronavirus virus 2 (SARS-CoV-2) cluster with interfacility spread during the SARS-CoV-2 δ (delta) pandemic surge in the Midwest.
Setting: This study was conducted in (1) a hematology-oncology ward in a regional academic medical center and (2) a geographically distant acute rehabilitation hospital.
Methods: We conducted contact tracing for each COVID-19 case to identify healthcare exposures within 14 days prior to diagnosis. Liberal testing was performed for asymptomatic carriage for patients and staff. Whole-genome sequencing was conducted for all available clinical isolates from patients and healthcare workers (HCWs) to identify transmission clusters.
Results: In the immunosuppressed ward, 19 cases (4 patients, 15 HCWs) shared a genetically related SARS-CoV-2 isolate. Of these 4 patients, 3 died in the hospital or within 1 week of discharge. The suspected index case was a patient with new dyspnea, diagnosed during preprocedure screening. In the rehabilitation hospital, 20 cases (5 patients and 15 HCWs) positive for COVID-19, of whom 2 patients and 3 HCWs had an isolate genetically related to the above cluster. The suspected index case was a patient from the immune suppressed ward whose positive status was not detected at admission to the rehabilitation facility. Our response to this cluster included the following interventions in both settings: restricting visitors, restricting learners, restricting overflow admissions, enforcing strict compliance with escalated PPE, access to on-site free and frequent testing for staff, and testing all patients prior to hospital discharge and transfer to other facilities.
Conclusions: Stringent infection control measures can prevent nosocomial COVID-19 transmission in healthcare facilities with high-risk patients during pandemic surges. These interventions were successful in ending these outbreaks.
. 2024 Jan 4:1-9.
doi: 10.1017/ice.2023.172. Online ahead of print. A severe acute respiratory coronavirus virus 2 (SARS-CoV-2) nosocomial cluster with inter-facility spread: Lessons learned
Aurora E Pop-Vicas[SUP] 1 [/SUP], Laura Anderson[SUP] 2 [/SUP], Gabrielle Hatas[SUP] 2 [/SUP], Linda Stevens[SUP] 3 [/SUP], Ashley Buys[SUP] 4 [/SUP], David O'Connor[SUP] 5 [/SUP], Nancy Wilson[SUP] 5 [/SUP], Kasen Riemersma[SUP] 5 [/SUP], Luis A Haddock Soto[SUP] 5 [/SUP], Abby Richardson[SUP] 6 [/SUP], Christine Clemens[SUP] 6 [/SUP], Jennylynde Packham[SUP] 6 [/SUP], Daniel Shirley[SUP] 1 [/SUP], Nasia Safdar[SUP] 1 7 [/SUP]
Affiliations
- PMID: 38173365
- DOI: 10.1017/ice.2023.172
Background: Despite infection control guidance, sporadic nosocomial coronavirus disease 2019 (COVID-19) outbreaks occur. We describe a complex severe acute respiratory coronavirus virus 2 (SARS-CoV-2) cluster with interfacility spread during the SARS-CoV-2 δ (delta) pandemic surge in the Midwest.
Setting: This study was conducted in (1) a hematology-oncology ward in a regional academic medical center and (2) a geographically distant acute rehabilitation hospital.
Methods: We conducted contact tracing for each COVID-19 case to identify healthcare exposures within 14 days prior to diagnosis. Liberal testing was performed for asymptomatic carriage for patients and staff. Whole-genome sequencing was conducted for all available clinical isolates from patients and healthcare workers (HCWs) to identify transmission clusters.
Results: In the immunosuppressed ward, 19 cases (4 patients, 15 HCWs) shared a genetically related SARS-CoV-2 isolate. Of these 4 patients, 3 died in the hospital or within 1 week of discharge. The suspected index case was a patient with new dyspnea, diagnosed during preprocedure screening. In the rehabilitation hospital, 20 cases (5 patients and 15 HCWs) positive for COVID-19, of whom 2 patients and 3 HCWs had an isolate genetically related to the above cluster. The suspected index case was a patient from the immune suppressed ward whose positive status was not detected at admission to the rehabilitation facility. Our response to this cluster included the following interventions in both settings: restricting visitors, restricting learners, restricting overflow admissions, enforcing strict compliance with escalated PPE, access to on-site free and frequent testing for staff, and testing all patients prior to hospital discharge and transfer to other facilities.
Conclusions: Stringent infection control measures can prevent nosocomial COVID-19 transmission in healthcare facilities with high-risk patients during pandemic surges. These interventions were successful in ending these outbreaks.