Kohlmorgen Britta, Brodzinski Annika, Jendrossek Sandra, Jeske Thorsten, Putsch Anne-Kathrin, Weisker Maja, Schneider Sandra, Schwab Frank, Gastmeier Petra, Hansen Sonja
Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Hygiene and Environmental Medicine, Berlin, Germany.
DRK Kliniken Berlin, Institute for Hygiene, Berlin, Germany.
GMS Hyg Infect Control. 2024 Apr 17;19:Doc19. doi: 10.3205/dgkh000474. eCollection 2024.
SARS-CoV-2 hospital clusters are a challenge for healthcare systems. There is an increased risk of infection for both healthcare workers (HCWs) and patients; cluster countermeasures are also a drain on resources for the wards affected. We analysed to which extent characteristics and dynamics of SARS-CoV-2 clusters varied throughout the pandemic at a German university hospital.
Patient and/or HCW clusters from 10/2020 to 04/2022 were included in the study and grouped by virus variant into i.) clusters comprised of the presumably predominant wild-type, Alpha or Delta (WAD) SARS-COV-2 variants, and ii.) clusters comprised predominantly of Omicron subtype cases. The two groups were compared for specific characteristics and dynamics.
Forty-two SARS-CoV-2 clusters and 528 cases were analysed. Twenty-one clusters and 297 cases were attributed to the WAD and 21 clusters and 231 cases to the Omicron group. There were no significant differences in median size (8 vs. 8 cases, p=0.94) or median duration (14 vs. 12 days; p=0.48), nor in the percentage of HCWs involved (46.8% vs. 50.2%; p=0.48). Patients in the WAD group were older (median 75 vs. 68 years of age; p≤0.05). The median time from cluster onset to case onset was significantly shorter for the Omicron group (median 6 vs. 11 days; p≤0.05).
Omicron clusters exhibited a more rapid dynamic, forcing all parties involved to adapt to the increased workload. Compared to excessive community case counts, constant Omicron cluster-affiliated case counts and stable cluster characteristics suggest an improved compliance with IPC countermeasures.
严重急性呼吸综合征冠状病毒2（SARS-CoV-2）医院聚集性感染对医疗系统构成挑战。医护人员（HCW）和患者的感染风险均会增加；聚集性感染应对措施也会消耗受影响病房的资源。我们分析了德国一家大学医院在整个疫情期间SARS-CoV-2聚集性感染的特征和动态变化程度。
将2020年10月至2022年4月期间的患者和/或HCW聚集性感染纳入研究，并根据病毒变异株分为：i.）由可能占主导地位的野生型、阿尔法或德尔塔（WAD）SARS-CoV-2变异株组成的聚集性感染，以及ii.）主要由奥密克戎亚型病例组成的聚集性感染。比较两组的具体特征和动态变化。
分析了42个SARS-CoV-2聚集性感染和528例病例。21个聚集性感染和297例病例归因于WAD组，21个聚集性感染和231例病例归因于奥密克戎组。在聚集性感染的中位数规模（8例对8例，p = 0.94）、中位数持续时间（14天对12天；p = 0.48）或涉及的HCW百分比（46.8%对50.2%；p = 0.48）方面没有显著差异。WAD组的患者年龄更大（中位数75岁对68岁；p≤0.05）。奥密克戎组从聚集性感染开始到病例出现的中位数时间显著更短（中位数6天对11天；p≤0.05）。
奥密克戎聚集性感染呈现出更快的动态变化，迫使所有相关方适应增加的工作量。与社区病例数过多相比，持续的奥密克戎聚集性感染相关病例数和稳定的聚集性感染特征表明对感染预防与控制措施的依从性有所提高。
