Infection Control Unit, Grenoble Alpes University Hospital, Grenoble, France.
Grenoble Alpes University/CNRS, Grenoble INP, MESP TIM-C UMR 5525, Grenoble, France.
Antimicrob Resist Infect Control. 2021 Aug 5;10(1):114. doi: 10.1186/s13756-021-00984-x.
In healthcare facilities, nosocomial transmissions of respiratory viruses are a major issue. SARS-CoV-2 is not exempt from nosocomial transmission. Our goals were to describe COVID-19 nosocomial cases during the first pandemic wave among patients in a French university hospital and compliance with hygiene measures.
We conducted a prospective observational study in Grenoble Alpes University Hospital from 01/03/2020 to 11/05/2020. We included all hospitalised patients with a documented SARS-CoV-2 diagnosis. Nosocomial case was defined by a delay of 5 days between hospitalisation and first symptoms. Hygiene measures were evaluated between 11/05/2020 and 22/05/2020. Lockdown measures were effective in France on 17/03/2020 and ended on 11/05/2020. Systematic wearing of mask was mandatory for all healthcare workers (HCW) and visits were prohibited in our institution from 13/03/2021 and for the duration of the lockdown period.
Among 259 patients included, 14 (5.4%) were considered as nosocomial COVID-19. Median time before symptom onset was 25 days (interquartile range: 12-42). Eleven patients (79%) had risk factors for severe COVID-19. Five died (36%) including 4 deaths attributable to COVID-19. Two clusters were identified. The first cluster had 5 cases including 3 nosocomial acquisitions and no tested HCWs were positive. The second cluster had 3 cases including 2 nosocomial cases and 4 HCWs were positive. Surgical mask wearing and hand hygiene compliance were adequate for 95% and 61% of HCWs, respectively.
The number of nosocomial COVID-19 cases in our hospital was low. Compliance regarding mask wearing, hand hygiene and lockdown measures drastically reduced transmission of the virus. Monitoring of nosocomial COVID-19 cases during the first wave enabled us to determine to what extent the hygiene measures taken were effective and patients protected. Trial registration Study ethics approval was obtained retrospectively on 30 September 2020 (CECIC Rhône-Alpes-Auvergne, Clermont-Ferrand, IRB 5891).
在医疗机构中，呼吸道病毒的医院内传播是一个主要问题。SARS-CoV-2 也不能免除医院内传播。我们的目标是描述法国一家大学医院在第一次大流行期间 COVID-19 医院内病例以及卫生措施的遵守情况。
我们在格勒诺布尔阿尔卑斯大学医院进行了一项前瞻性观察研究，时间为 2020 年 3 月 1 日至 5 月 11 日。我们纳入了所有有记录的 SARS-CoV-2 诊断的住院患者。医院内病例的定义是住院后和首次症状之间有 5 天的延迟。卫生措施的评估时间为 2020 年 5 月 11 日至 22 日。法国于 2020 年 3 月 17 日实施封锁措施，于 5 月 11 日结束。所有医护人员（HCW）必须系统地佩戴口罩，自 2020 年 3 月 13 日起，我们医院禁止探访，且封锁期间一直如此。
在纳入的 259 名患者中，有 14 名（5.4%）被认为是 COVID-19 医院内病例。症状出现前的中位时间为 25 天（四分位间距：12-42）。11 名患者（79%）有 COVID-19 重症的危险因素。5 人死亡（36%），其中 4 人归因于 COVID-19。确定了两个聚集性病例。第一个聚集性病例有 5 例，包括 3 例医院内获得性病例，没有检测到 HCW 阳性。第二个聚集性病例有 3 例，包括 2 例医院内病例和 4 例 HCW 阳性。口罩佩戴和手部卫生的依从性分别为 95%和 61%。
我们医院的 COVID-19 医院内病例数量较少。口罩佩戴、手部卫生和封锁措施的遵守情况大大降低了病毒的传播。在第一次大流行期间对 COVID-19 医院内病例的监测使我们能够确定所采取的卫生措施在多大程度上有效保护了患者。
研究伦理批准于 2020 年 9 月 30 日（罗纳-阿尔卑斯大区中央委员会，克莱蒙费朗，IRB 5891）获得回顾性批准。
