Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpital Pitié-Salpêtrière, Service de Virologie, Paris, France.
Unité de Prévention du Risque Infectieux, Hôpital Saint-Antoine, GH Sorbonne Université, AP-HP, Paris, France.
Microbiol Res. 2022 Oct;263:127133. doi: 10.1016/j.micres.2022.127133. Epub 2022 Jul 22.
Despite the quick implementation of infection prevention and control procedures and the use of personal protective equipment within healthcare facilities, many cases of nosocomial COVID-19 transmission have been reported. We aimed to estimate the frequency and impact of healthcare-associated COVID-19 (HA-COVID-19) and evaluate the contribution of whole-genome sequencing (WGS) in cluster investigation.
We estimated the frequency and mortality of HA-COVID-19 infections from September 1 to November 30, 2020, with a focus on the evolution of hospitalized community-associated COVID-19 (CA-COVID-19) cases and cases detected among healthcare workers (HCWs) within the Sorbonne University Hospital Group (Paris, France). We thoroughly examined 12 clusters through epidemiological investigations and WGS.
Overall, 209 cases of HA-COVID-19 were reported. Evolution of HA-COVID-19 incidence closely correlated with the incidence of CA-COVID-19 and COVID-19 among HCWs. During the study period, 13.9 % of hospitalized patients with COVID-19 were infected in the hospital and the 30-day mortality rate of HA-COVID-19 was 31.5 %. Nosocomial transmission of SARS-CoV-2 led to clusters involving both patients and HCWs. WGS allowed the exclusion of one-third of cases initially assigned to a cluster.
WGS analysis combined with comprehensive epidemiological investigations is essential to understand transmission routes and adapt the IPC response to protect both patients and HCWs.
尽管医疗机构内迅速实施了感染预防和控制程序并使用了个人防护设备，但仍有许多医院获得性 COVID-19 传播病例报告。我们旨在评估医疗保健相关 COVID-19（HA-COVID-19）的频率和影响，并评估全基因组测序（WGS）在集群调查中的作用。
我们估计了 2020 年 9 月 1 日至 11 月 30 日期间 HA-COVID-19 感染的频率和死亡率，重点关注住院社区获得性 COVID-19（CA-COVID-19）病例和医疗机构工作人员（HCWs）中检测到的病例的演变在索邦大学医院集团（巴黎，法国）。我们通过流行病学调查和 WGS 彻底检查了 12 个集群。
总体而言，报告了 209 例 HA-COVID-19 病例。HA-COVID-19 发病率的演变与 CA-COVID-19 和 HCWs 中的 COVID-19 发病率密切相关。在研究期间，13.9%的 COVID-19 住院患者在医院内感染，HA-COVID-19 的 30 天死亡率为 31.5%。SARS-CoV-2 的医院传播导致了涉及患者和 HCWs 的集群。WGS 分析排除了最初分配给一个集群的三分之一的病例。
WGS 分析结合全面的流行病学调查对于了解传播途径和调整 IPC 反应以保护患者和 HCWs 至关重要。
