荷兰南部三家医院医护人员中的 COVID-19：一项横断面研究。
COVID-19 in health-care workers in three hospitals in the south of the Netherlands: a cross-sectional study.
机构信息
Viroscience, Erasmus MC, Rotterdam, Netherlands.
Microvida Laboratory for Microbiology, Bravis Hospital, Roosendaal, Netherlands; Microvida Laboratory for Microbiology, Amphia Hospital, Breda, Netherlands.
出版信息
Lancet Infect Dis. 2020 Nov;20(11):1273-1280. doi: 10.1016/S1473-3099(20)30527-2. Epub 2020 Jul 2.
BACKGROUND
10 days after the first reported case of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in the Netherlands (on Feb 27, 2020), 55 (4%) of 1497 health-care workers in nine hospitals located in the south of the Netherlands had tested positive for SARS-CoV-2 RNA. We aimed to gain insight in possible sources of infection in health-care workers.
METHODS
We did a cross-sectional study at three of the nine hospitals located in the south of the Netherlands. We screened health-care workers at the participating hospitals for SARS-CoV-2 infection, based on clinical symptoms (fever or mild respiratory symptoms) in the 10 days before screening. We obtained epidemiological data through structured interviews with health-care workers and combined this information with data from whole-genome sequencing of SARS-CoV-2 in clinical samples taken from health-care workers and patients. We did an in-depth analysis of sources and modes of transmission of SARS-CoV-2 in health-care workers and patients.
FINDINGS
Between March 2 and March 12, 2020, 1796 (15%) of 12 022 health-care workers were screened, of whom 96 (5%) tested positive for SARS-CoV-2. We obtained complete and near-complete genome sequences from 50 health-care workers and ten patients. Most sequences were grouped in three clusters, with two clusters showing local circulation within the region. The noted patterns were consistent with multiple introductions into the hospitals through community-acquired infections and local amplification in the community.
INTERPRETATION
Although direct transmission in the hospitals cannot be ruled out, our data do not support widespread nosocomial transmission as the source of infection in patients or health-care workers.
FUNDING
EU Horizon 2020 (RECoVer, VEO, and the European Joint Programme One Health METASTAVA), and the National Institute of Allergy and Infectious Diseases, National Institutes of Health.
背景
2020 年 2 月 27 日，荷兰报告首例严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）感染病例 10 天后，荷兰南部 9 家医院的 1497 名医护人员中，有 55 名（4%）的 SARS-CoV-2 RNA 检测呈阳性。我们旨在深入了解医护人员感染的可能来源。
方法
我们在荷兰南部的 3 家 9 家医院之一进行了一项横断面研究。我们根据筛查前 10 天的临床症状（发热或轻度呼吸道症状），对参与医院的医护人员进行 SARS-CoV-2 感染筛查。我们通过对医护人员进行结构化访谈获得流行病学数据，并将这些信息与从医护人员和患者采集的临床样本中进行的 SARS-CoV-2 全基因组测序数据相结合。我们对医护人员和患者中 SARS-CoV-2 的来源和传播模式进行了深入分析。
结果
2020 年 3 月 2 日至 3 月 12 日，对 12022 名医护人员中的 1796 名（15%）进行了筛查，其中 96 名（5%）的 SARS-CoV-2 检测呈阳性。我们从 50 名医护人员和 10 名患者中获得了完整和近乎完整的基因组序列。大多数序列分为三个簇，其中两个簇显示出该地区内的局部循环。注意到的模式与通过社区获得性感染进入医院并在社区中局部扩增的多次引入相一致。
解释
虽然不能排除医院内的直接传播，但我们的数据不支持医院内传播是患者或医护人员感染的主要来源。
资助
欧盟地平线 2020（RECoVer、VEO 和欧洲联合计划 One Health METASTAVA）以及美国国立过敏和传染病研究所，美国国立卫生研究院。
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