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Containment of COVID-19 and reduction in healthcare-associated respiratory viral infections through a multi-tiered infection control strategy

BACKGROUND: During the ongoing COVID-19 pandemic, healthcare-associated transmission of respiratory viral infections (RVI) is a concern. To reduce the impact of SARS-CoV-2 and other respiratory viruses on patients and healthcare workers (HCWs) we devised and evaluated a multi-tiered infection contro...

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Detalles Bibliográficos
Autores principales: Wee, Liang En, Venkatachalam, Indumathi, Sim, Xiang Ying Jean, Tan, Kenneth Boon-Kiat, Wen, Ruan, Tham, Chee Kian, Gan, Wee Hoe, Ko, Kwan Ki Karrie, Ho, Wan Qi, Kwek, Grace Teck Cheng, Conceicao, Edwin Philip, Sng, Chong Yu Edwin, Ng, Xin Hui Jorin, Ong, Jie Yi, Chiang, Juat Lan, Chua, Ying Ying, Ling, Moi Lin, Tan, Thuan Tong, Wijaya, Limin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Australasian College for Infection Prevention and Control. Published by Elsevier B.V. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7667403/
https://www.ncbi.nlm.nih.gov/pubmed/33386294
http://dx.doi.org/10.1016/j.idh.2020.11.004
Descripción
Sumario:BACKGROUND: During the ongoing COVID-19 pandemic, healthcare-associated transmission of respiratory viral infections (RVI) is a concern. To reduce the impact of SARS-CoV-2 and other respiratory viruses on patients and healthcare workers (HCWs) we devised and evaluated a multi-tiered infection control strategy with the goal of preventing nosocomial transmission of SARS-CoV2 and other RVIs across a large healthcare campus. METHODS: From January–June 2020, a multi-tiered infection control strategy was implemented across a healthcare campus in Singapore, comprising the largest acute tertiary hospital as well as four other subspecialty centres, with more than 10,000 HCWs. Drawing on our institution's experience with an outbreak of Severe Acute Respiratory Syndrome (SARS) in 2003, this strategy included improved patient segregation and distancing, and heightened infection prevention and control (IPC) measures including universal masking. All symptomatic patients were tested for COVID-19 and common RVIs. RESULTS: A total of 16,162 admissions campus-wide were screened; 7.1% (1155/16,162) tested positive for COVID-19. Less than 5% of COVID-19 cases (39/1155) were initially detected outside of isolation wards in multi-bedded cohorted wards. Improved distancing and enhanced IPC measures successfully mitigated onward spread even amongst COVID-19 cases detected outside of isolation. COVID-19 rates amongst HCWs were kept low (0.13%, 17/13,066) and reflected community acquisition rather than nosocomial spread. Rates of healthcare-associated-RVI amongst inpatients fell to zero and this decrease was sustained even after the lifting of visitor restrictions. CONCLUSION: This multi-tiered infection control strategies can be implemented at-scale to successfully mitigate healthcare-associated transmission of respiratory viral pathogens.