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An outbreak of infection due to severe acute respiratory corona virus-2 in a neonatal unit from a low and middle income setting
INTRODUCTION: The provision of kangaroo mother care (KMC) involving continuous skin-to-skin care (SSC) is an important intervention in neonatal care, which is recommended even when women are infected with severe acute respiratory syndrome coronavirus (SARS-CoV-2). We report on a nosocomial outbreak...
Autores principales: | , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9366465/ https://www.ncbi.nlm.nih.gov/pubmed/35967580 http://dx.doi.org/10.3389/fped.2022.933982 |
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author | Nakwa, Firdose Lambey Thomas, Reenu van Kwawegen, Alison Ntuli, Nandi Seake, Karabo Kesting, Samantha Jane Kamanga, Noela Holo Bertha Kgwadi, Dikeledi Maureen Chami, Neema Mogajane, Tshiamo Ondongo-Ezhet, Claude Maphosa, Thulisile Nelly Jones, Stephanie Baillie, Vicky Lynne Madhi, Shabir Ahmed Velaphi, Sithembiso |
author_facet | Nakwa, Firdose Lambey Thomas, Reenu van Kwawegen, Alison Ntuli, Nandi Seake, Karabo Kesting, Samantha Jane Kamanga, Noela Holo Bertha Kgwadi, Dikeledi Maureen Chami, Neema Mogajane, Tshiamo Ondongo-Ezhet, Claude Maphosa, Thulisile Nelly Jones, Stephanie Baillie, Vicky Lynne Madhi, Shabir Ahmed Velaphi, Sithembiso |
author_sort | Nakwa, Firdose Lambey |
collection | PubMed |
description | INTRODUCTION: The provision of kangaroo mother care (KMC) involving continuous skin-to-skin care (SSC) is an important intervention in neonatal care, which is recommended even when women are infected with severe acute respiratory syndrome coronavirus (SARS-CoV-2). We report on a nosocomial outbreak of SARS-CoV-2 infections in a KMC ward. METHODS: Contact tracing was conducted following the diagnosis of SARS-CoV-2 in a mother lodging in the KMC ward. All mother-newborn dyads in the KMC and healthcare workers (HCW) were tested for SARS-CoV-2 within 24–72 h of diagnosing the index case. Nasopharyngeal swab samples were obtained and tested from contacts, with a nucleic acid amplification test (NAAT) assay. Next-generation sequencing was done on positive samples. The secondary attack rate (SAR) was calculated assuming that the mother who presented with symptoms was the source of infection. RESULTS: Twelve (70.6%) of 17 mothers and 8 (42.1%) of 19 neonates who were in the KMC ward with the index case were found to be positive with SARS-CoV-2. Seven (87.5%) of the 8 neonates who tested positive had mothers who also tested positive. Seventy-five percent (9/12) of the mothers and 62.5% (5/8) of the neonates who tested positive were asymptomatic. Eight (27.6%) of 29 HCW were found to be positive and were all asymptomatic. One neonate died from Acinetobacter baumannii sepsis, and his post-mortem lung histopathology showed features compatible with SARS-CoV-2 pneumonia. The sequencing of 13 specimens, which included 1 mother-newborn dyad, indicated clustering to the same phylogenetic lineage with identical mutations. In assessing for factors contributing to this outbreak, it was found that spaces between beds were less than 1 m and mothers had their meals around the same table at the same time. CONCLUSION: We report on a nosocomial outbreak of SARS-CoV-2 in a KMC ward, affecting a high number of mothers and neonates, and to a lesser extent HCWs. Although it is difficult to point to the index case as the source of this outbreak, as asymptomatic individuals can spread infection, the inadequate adherence to non-pharmaceutical interventions was assessed to have contributed to the spread of infection. This highlights the need for awareness and adherence to mitigation strategies to avoid SARS-CoV-2 outbreaks. |
format | Online Article Text |
id | pubmed-9366465 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-93664652022-08-12 An outbreak of infection due to severe acute respiratory corona virus-2 in a neonatal unit from a low and middle income setting Nakwa, Firdose Lambey Thomas, Reenu van Kwawegen, Alison Ntuli, Nandi Seake, Karabo Kesting, Samantha Jane Kamanga, Noela Holo Bertha Kgwadi, Dikeledi Maureen Chami, Neema Mogajane, Tshiamo Ondongo-Ezhet, Claude Maphosa, Thulisile Nelly Jones, Stephanie Baillie, Vicky Lynne Madhi, Shabir Ahmed Velaphi, Sithembiso Front Pediatr Pediatrics INTRODUCTION: The provision of kangaroo mother care (KMC) involving continuous skin-to-skin care (SSC) is an important intervention in neonatal care, which is recommended even when women are infected with severe acute respiratory syndrome coronavirus (SARS-CoV-2). We report on a nosocomial outbreak of SARS-CoV-2 infections in a KMC ward. METHODS: Contact tracing was conducted following the diagnosis of SARS-CoV-2 in a mother lodging in the KMC ward. All mother-newborn dyads in the KMC and healthcare workers (HCW) were tested for SARS-CoV-2 within 24–72 h of diagnosing the index case. Nasopharyngeal swab samples were obtained and tested from contacts, with a nucleic acid amplification test (NAAT) assay. Next-generation sequencing was done on positive samples. The secondary attack rate (SAR) was calculated assuming that the mother who presented with symptoms was the source of infection. RESULTS: Twelve (70.6%) of 17 mothers and 8 (42.1%) of 19 neonates who were in the KMC ward with the index case were found to be positive with SARS-CoV-2. Seven (87.5%) of the 8 neonates who tested positive had mothers who also tested positive. Seventy-five percent (9/12) of the mothers and 62.5% (5/8) of the neonates who tested positive were asymptomatic. Eight (27.6%) of 29 HCW were found to be positive and were all asymptomatic. One neonate died from Acinetobacter baumannii sepsis, and his post-mortem lung histopathology showed features compatible with SARS-CoV-2 pneumonia. The sequencing of 13 specimens, which included 1 mother-newborn dyad, indicated clustering to the same phylogenetic lineage with identical mutations. In assessing for factors contributing to this outbreak, it was found that spaces between beds were less than 1 m and mothers had their meals around the same table at the same time. CONCLUSION: We report on a nosocomial outbreak of SARS-CoV-2 in a KMC ward, affecting a high number of mothers and neonates, and to a lesser extent HCWs. Although it is difficult to point to the index case as the source of this outbreak, as asymptomatic individuals can spread infection, the inadequate adherence to non-pharmaceutical interventions was assessed to have contributed to the spread of infection. This highlights the need for awareness and adherence to mitigation strategies to avoid SARS-CoV-2 outbreaks. Frontiers Media S.A. 2022-07-28 /pmc/articles/PMC9366465/ /pubmed/35967580 http://dx.doi.org/10.3389/fped.2022.933982 Text en Copyright © 2022 Nakwa, Thomas, van Kwawegen, Ntuli, Seake, Kesting, Kamanga, Kgwadi, Chami, Mogajane, Ondongo-Ezhet, Maphosa, Jones, Baillie, Madhi and Velaphi. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Pediatrics Nakwa, Firdose Lambey Thomas, Reenu van Kwawegen, Alison Ntuli, Nandi Seake, Karabo Kesting, Samantha Jane Kamanga, Noela Holo Bertha Kgwadi, Dikeledi Maureen Chami, Neema Mogajane, Tshiamo Ondongo-Ezhet, Claude Maphosa, Thulisile Nelly Jones, Stephanie Baillie, Vicky Lynne Madhi, Shabir Ahmed Velaphi, Sithembiso An outbreak of infection due to severe acute respiratory corona virus-2 in a neonatal unit from a low and middle income setting |
title | An outbreak of infection due to severe acute respiratory corona virus-2 in a neonatal unit from a low and middle income setting |
title_full | An outbreak of infection due to severe acute respiratory corona virus-2 in a neonatal unit from a low and middle income setting |
title_fullStr | An outbreak of infection due to severe acute respiratory corona virus-2 in a neonatal unit from a low and middle income setting |
title_full_unstemmed | An outbreak of infection due to severe acute respiratory corona virus-2 in a neonatal unit from a low and middle income setting |
title_short | An outbreak of infection due to severe acute respiratory corona virus-2 in a neonatal unit from a low and middle income setting |
title_sort | outbreak of infection due to severe acute respiratory corona virus-2 in a neonatal unit from a low and middle income setting |
topic | Pediatrics |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9366465/ https://www.ncbi.nlm.nih.gov/pubmed/35967580 http://dx.doi.org/10.3389/fped.2022.933982 |
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