Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea.
PLoS One. 2022 Nov 21;17(11):e0277816. doi: 10.1371/journal.pone.0277816. eCollection 2022.
The COVID-19 pandemic becomes a cause of concern for hospital transmission. Caregivers may play an important role as vectors for nosocomial infections; however, infection control for caregivers often is neglected. A nosocomial COVID-19 outbreak occurred in a 768-bed hospital from March 20, 2020, to April 14, 2020. We conducted a retrospective chart review and epidemiologic investigation on all cases. A total of 54 cases of laboratory-confirmed COVID-19 occurred in the community-based hospital. They included 26 (48.1%) patients, 21 (38.9%) caregivers, and 7 (13.0%) healthcare workers. These 21 caregivers cared for 18 patients, and of these, 9 were positive for COVID-19, 6 were negative, and 3 died before testing. Of the 6 negative patients, 3 had no exposure because the caregiver began to show symptoms at least 5 days after their discharge. Of the 9 positive patients, 4 cases of transmission took place from patient to caregiver (one patient transmitted COVID-19 to two caregivers), and 6 cases of transmission occurred from caregiver to patient. Of the 54 hospital-acquired cases, 38 occurred in the 8th-floor ward and 8 occurred in the 4th-floor ward. The index case of each ward was a caregiver. Counting the number of cases where transmission occurred only between patients and their own caregivers, 9 patients were suspected of having exposure to COVID-19 from their own caregivers. Six patients (66.7%) were infected by COVID-19-confirmed caregivers, and 3 patients were uninfected. Fewer patients among the infected were able to perform independent activities compared to uninfected patients. Not only patients and healthcare workers but also caregivers groups may be vulnerable to COVID-19 and be transmission sources of nosocomial outbreaks. Therefore, infection control programs for caregivers in addition to patients and healthcare workers can be equally important.
新冠疫情引发了医院内传播的担忧。医护人员可能在院内感染中充当了重要的媒介；然而，医护人员的感染防控往往被忽视。2020 年 3 月 20 日至 4 月 14 日，一家拥有 768 张床位的医院发生了一起新冠院内感染事件。我们对所有病例进行了回顾性病历审查和流行病学调查。这家社区医院共发生了 54 例经实验室确诊的新冠病例。其中 26 例（48.1%）为患者，21 例（38.9%）为医护人员，7 例（13.0%）为医护人员。这 21 名医护人员照顾了 18 名患者，其中 9 名患者新冠病毒检测呈阳性，6 名患者新冠病毒检测呈阴性，3 名患者在检测前死亡。在 6 名检测结果为阴性的患者中，有 3 名因医护人员在他们出院至少 5 天后才出现症状而没有接触。在 9 名检测结果为阳性的患者中，有 4 例是从患者传染给医护人员（一名患者传染给了两名医护人员），有 6 例是从医护人员传染给患者。在这 54 例院内感染病例中，有 38 例发生在 8 楼病房，8 例发生在 4 楼病房。每个病房的感染源都是一名医护人员。仅计算患者与其各自的医护人员之间发生传播的病例数，有 9 名患者疑似从各自的医护人员处感染新冠病毒。有 6 名患者（66.7%）被新冠病毒检测阳性的医护人员感染，3 名患者未被感染。与未被感染的患者相比，感染的患者中能够独立活动的人数更少。不仅是患者和医护人员，医护人员群体也可能容易感染新冠病毒，并成为医院感染暴发的传染源。因此，除了患者和医护人员外，医护人员的感染防控工作也同样重要。
