Nosocomial or not? A combined epidemiological and genomic investigation to understand hospital-acquired COVID-19 infection on an elderly care ward.

Autor:	Wenlock RD; Brighton and Sussex University Hospitals NHS Trust, Brighton, UK., Tausan M; Brighton and Sussex University Hospitals NHS Trust, Brighton, UK., Mann R; Brighton and Sussex University Hospitals NHS Trust, Brighton, UK., Garr W; Brighton and Sussex University Hospitals NHS Trust, Brighton, UK., Preston R; Brighton and Sussex University Hospitals NHS Trust, Brighton, UK., Arnold A; Brighton and Sussex University Hospitals NHS Trust, Brighton, UK., Hoban J; Brighton and Sussex University Hospitals NHS Trust, Brighton, UK., Webb L; Brighton and Sussex University Hospitals NHS Trust, Brighton, UK., Quick C; Brighton and Sussex University Hospitals NHS Trust, Brighton, UK., Beckett A; Centre for Enzyme Innovation, University of Portsmouth, Portsmouth, UK., Loveson K; School of Pharmacy and Biomedical Science, University of Portsmouth, Portsmouth, UK., Glaysher S; Portsmouth Hospitals University NHS Trust, Portsmouth, UK., Elliott S; Portsmouth Hospitals University NHS Trust, Portsmouth, UK., Malone C; Brighton and Sussex University Hospitals NHS Trust, Brighton, UK., Cogger B; Brighton and Sussex University Hospitals NHS Trust, Brighton, UK., Easton L; Brighton and Sussex University Hospitals NHS Trust, Brighton, UK., Robson SC; Centre for Enzyme Innovation, University of Portsmouth, Portsmouth, UK.; School of Pharmacy and Biomedical Science, University of Portsmouth, Portsmouth, UK., Hassan-Ibrahim MO; Brighton and Sussex University Hospitals NHS Trust, Brighton, UK., Sargent C; Brighton and Sussex University Hospitals NHS Trust, Brighton, UK.
Jazyk:	angličtina
Zdroj:	Infection prevention in practice [Infect Prev Pract] 2021 Sep; Vol. 3 (3), pp. 100165. Date of Electronic Publication: 2021 Aug 28.
DOI:	10.1016/j.infpip.2021.100165
Abstrakt:	Background: COVID-19 has the potential to cause outbreaks in hospitals. Given the comorbid and elderly cohort of patients hospitalized, hospital-acquired COVID-19 infection is often fatal. Pathogen genome sequencing is becoming increasingly important in infection prevention and control (IPC). Aim: To inform the understanding of in-hospital SARS-CoV-2 transmission in order to improve IPC practices and to inform the future development of virological testing for IPC. Methods: Patients detected COVID-19 positive by polymerase chain reaction on Ward A in April and May 2020 were included with contact tracing to identify other potential cases. Genome sequencing was undertaken for a subgroup of cases. Epidemiological, genomic, and cluster analyses were performed to describe the epidemiology and to identify factors contributing to the outbreak. Findings: Fourteen cases were identified on Ward A. Contact tracing identified 16 further patient cases; in addition, eight healthcare workers (HCWs) were identified as being COVID-19 positive through a round of asymptomatic testing. Genome sequencing of 16 of these cases identified viral genomes differing by two single nucleotide polymorphisms or fewer, with further cluster analysis identifying two groups of infection (a five-person group and a six-person group). Conclusion: Despite the temporal relationship of cases, genome sequencing identified that not all cases shared transmission events. However, 11 samples were found to be closely related and these likely represented in-hospital transmission. This included three HCWs, thereby confirming transmission between patients and HCWs. (© 2021 The Authors.)
Databáze:	MEDLINE
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