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Case-control study evaluating risk factors for SARS-CoV-2 outbreak amongst healthcare personnel at a tertiary care center

BACKGROUND: Despite several outbreaks of SARS-CoV-2 amongst healthcare personnel (HCP) exposed to COVID-19 patients globally, risk factors for transmission remain poorly understood. METHODS: We conducted an outbreak investigation and case-control study to evaluate SARS-CoV-2 transmission risk in an...

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Autores principales: Rosser, Joelle I, Tayyar, Ralph, Giardina, Richard, Kolonoski, Peter, Kenski, Diane, Shen, Peidong, Steinmetz, Lars M, Hung, Li-Yuan, Xiao, Wenzhong, Bains, Karen, Morrison, Timothy, Madison, Alexandra, Chang, Sang-ick, Tompkins, Lucy, Pinsky, Benjamin A, Holubar, Marisa
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8440319/
https://www.ncbi.nlm.nih.gov/pubmed/34536502
http://dx.doi.org/10.1016/j.ajic.2021.09.004
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author Rosser, Joelle I
Tayyar, Ralph
Giardina, Richard
Kolonoski, Peter
Kenski, Diane
Shen, Peidong
Steinmetz, Lars M
Hung, Li-Yuan
Xiao, Wenzhong
Bains, Karen
Morrison, Timothy
Madison, Alexandra
Chang, Sang-ick
Tompkins, Lucy
Pinsky, Benjamin A
Holubar, Marisa
author_facet Rosser, Joelle I
Tayyar, Ralph
Giardina, Richard
Kolonoski, Peter
Kenski, Diane
Shen, Peidong
Steinmetz, Lars M
Hung, Li-Yuan
Xiao, Wenzhong
Bains, Karen
Morrison, Timothy
Madison, Alexandra
Chang, Sang-ick
Tompkins, Lucy
Pinsky, Benjamin A
Holubar, Marisa
author_sort Rosser, Joelle I
collection PubMed
description BACKGROUND: Despite several outbreaks of SARS-CoV-2 amongst healthcare personnel (HCP) exposed to COVID-19 patients globally, risk factors for transmission remain poorly understood. METHODS: We conducted an outbreak investigation and case-control study to evaluate SARS-CoV-2 transmission risk in an outbreak among HCP at an academic medical center in California that was confirmed by whole genome sequencing. RESULTS: A total of 7/9 cases and 93/182 controls completed a voluntary survey about risk factors. Compared to controls, cases reported significantly more patient contact time. Cases were also significantly more likely to have performed airway procedures on the index patient, particularly placing the patient on high flow nasal cannula, continuous positive airway pressure (CPAP), or bilevel positive airway pressure (BiPAP) (OR = 11.6; 95% CI = 1.7 –132.1). DISCUSSION: This study highlights the risk of nosocomial infection of SARS-CoV-2 from patients who become infectious midway into their hospitalization. Our findings also reinforce the importance of patient contact time and aerosol-generating procedures as key risk factors for HCP infection with SARS-CoV-2. CONCLUSIONS: Re-testing patients for SARS-CoV-2 after admission in suspicious cases and using N95 masks for all aerosol-generating procedures regardless of initial patient SARS-CoV-2 test results can help reduce the risk of SARS-COV-2 transmission to HCP.
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spelling pubmed-84403192021-09-15 Case-control study evaluating risk factors for SARS-CoV-2 outbreak amongst healthcare personnel at a tertiary care center Rosser, Joelle I Tayyar, Ralph Giardina, Richard Kolonoski, Peter Kenski, Diane Shen, Peidong Steinmetz, Lars M Hung, Li-Yuan Xiao, Wenzhong Bains, Karen Morrison, Timothy Madison, Alexandra Chang, Sang-ick Tompkins, Lucy Pinsky, Benjamin A Holubar, Marisa Am J Infect Control Major Article BACKGROUND: Despite several outbreaks of SARS-CoV-2 amongst healthcare personnel (HCP) exposed to COVID-19 patients globally, risk factors for transmission remain poorly understood. METHODS: We conducted an outbreak investigation and case-control study to evaluate SARS-CoV-2 transmission risk in an outbreak among HCP at an academic medical center in California that was confirmed by whole genome sequencing. RESULTS: A total of 7/9 cases and 93/182 controls completed a voluntary survey about risk factors. Compared to controls, cases reported significantly more patient contact time. Cases were also significantly more likely to have performed airway procedures on the index patient, particularly placing the patient on high flow nasal cannula, continuous positive airway pressure (CPAP), or bilevel positive airway pressure (BiPAP) (OR = 11.6; 95% CI = 1.7 –132.1). DISCUSSION: This study highlights the risk of nosocomial infection of SARS-CoV-2 from patients who become infectious midway into their hospitalization. Our findings also reinforce the importance of patient contact time and aerosol-generating procedures as key risk factors for HCP infection with SARS-CoV-2. CONCLUSIONS: Re-testing patients for SARS-CoV-2 after admission in suspicious cases and using N95 masks for all aerosol-generating procedures regardless of initial patient SARS-CoV-2 test results can help reduce the risk of SARS-COV-2 transmission to HCP. Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. 2021-12 2021-09-15 /pmc/articles/PMC8440319/ /pubmed/34536502 http://dx.doi.org/10.1016/j.ajic.2021.09.004 Text en © 2021 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
spellingShingle Major Article
Rosser, Joelle I
Tayyar, Ralph
Giardina, Richard
Kolonoski, Peter
Kenski, Diane
Shen, Peidong
Steinmetz, Lars M
Hung, Li-Yuan
Xiao, Wenzhong
Bains, Karen
Morrison, Timothy
Madison, Alexandra
Chang, Sang-ick
Tompkins, Lucy
Pinsky, Benjamin A
Holubar, Marisa
Case-control study evaluating risk factors for SARS-CoV-2 outbreak amongst healthcare personnel at a tertiary care center
title Case-control study evaluating risk factors for SARS-CoV-2 outbreak amongst healthcare personnel at a tertiary care center
title_full Case-control study evaluating risk factors for SARS-CoV-2 outbreak amongst healthcare personnel at a tertiary care center
title_fullStr Case-control study evaluating risk factors for SARS-CoV-2 outbreak amongst healthcare personnel at a tertiary care center
title_full_unstemmed Case-control study evaluating risk factors for SARS-CoV-2 outbreak amongst healthcare personnel at a tertiary care center
title_short Case-control study evaluating risk factors for SARS-CoV-2 outbreak amongst healthcare personnel at a tertiary care center
title_sort case-control study evaluating risk factors for sars-cov-2 outbreak amongst healthcare personnel at a tertiary care center
topic Major Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8440319/
https://www.ncbi.nlm.nih.gov/pubmed/34536502
http://dx.doi.org/10.1016/j.ajic.2021.09.004
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