McDougal April N, Elhassani Dana, DeMaet Mary Ann, Shores Shirley, Plante Kenneth S, Plante Jessica A, Pyles Richard, Weaver Scott C, Williams-Bouyer Natalie, Tyler Brenda J, Davis Hollie R, Patel Janak
Department of Infection Control and Healthcare Epidemiology, University of Texas Medical Branch, Galveston, Texas.
Division of Infectious Disease, Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas.
Infect Control Hosp Epidemiol. 2022 Mar;43(3):319-325. doi: 10.1017/ice.2021.116. Epub 2021 Mar 19.
Investigate an outbreak of coronavirus disease 2019 (COVID-19) among operating room staff utilizing contact tracing, mass testing for severe acute respiratory coronavirus virus 2 (SARS-CoV-2), and environmental sampling.
Outbreak investigation.
University-affiliated tertiary-care referral center.
Operating room staff with positive SARS-CoV-2 molecular testing.
Epidemiologic and environmental investigations were conducted including contact tracing, environmental surveys, and sampling and review of the operating room schedule for staff-to-staff, staff-to-patient, and patient-to-staff SARS-CoV-2 transmission.
In total, 24 healthcare personnel (HCP) tested positive for SARS-CoV-2, including nurses (29%), surgical technologists (25%), and surgical residents (16%). Moreover, 19 HCP (79%) reported having used a communal area, most commonly break rooms (75%). Overall, 20 HCP (83%) reported symptomatic disease. In total, 72 environmental samples were collected from communal areas for SARS-CoV-2 genomic testing; none was positive. Furthermore, 236 surgical cases were reviewed for transmission: 213 (90%) had negative preoperative SARS-CoV-2 testing, 21 (9%) had a positive test on or before the date of surgery, and 2 (<1%) did not have a preoperative test performed. In addition, 40 patients underwent postoperative testing (mean, 13 days to postoperative testing), and 2 returned positive results. Neither of these 2 cases was linked to our outbreak.
Complacency in infection control practices among staff during peak community transmission of SARS-CoV-2 is believed to have driven staff-to-staff transmission. Prompt identification of the outbreak led to rapid interventions, ultimately allowing for uninterrupted surgical service.
利用接触者追踪、对严重急性呼吸综合征冠状病毒2（SARS-CoV-2）进行大规模检测以及环境采样，调查手术室工作人员中2019冠状病毒病（COVID-19）的暴发情况。
暴发调查。
大学附属三级医疗转诊中心。
SARS-CoV-2分子检测呈阳性的手术室工作人员。
进行了流行病学和环境调查，包括接触者追踪、环境调查、采样以及对手术室工作人员之间、工作人员与患者之间以及患者与工作人员之间SARS-CoV-2传播的手术日程安排进行审查。
共有24名医护人员（HCP）的SARS-CoV-2检测呈阳性，其中护士占29%，手术技师占25%，外科住院医师占16%。此外，19名医护人员（79%）报告曾使用公共区域，最常见的是休息室（75%）。总体而言，20名医护人员（83%）报告有症状性疾病。共从公共区域采集了72份环境样本进行SARS-CoV-2基因组检测；均为阴性。此外，对236例手术病例进行了传播审查：213例（90%）术前SARS-CoV-2检测为阴性，21例（9%）在手术日期当天或之前检测呈阳性，2例（<1%）未进行术前检测。另外，40例患者术后接受检测（术后检测平均时间为13天），2例结果呈阳性。这2例均与本次暴发无关。
在SARS-CoV-2社区传播高峰期，工作人员对感染控制措施的自满被认为是导致工作人员之间传播的原因。疫情的迅速识别导致了快速干预，最终使手术服务得以不间断进行。
