Factors contributing to a coronavirus disease 2019 (COVID-19) outbreak on a mixed medical-surgical unit in a Canadian acute-care hospital.

Autor:	McCallum MK; Infection Prevention and Control, Nova Scotia Health, Halifax, Nova Scotia, Canada., Patriquin G; Department of Pathology and Laboratory Medicine, Nova Scotia Health, Halifax, Nova Scotia, Canada.; Department of Pathology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.; Department of Medicine, Nova Scotia Health and Department of Medicine, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada., Davis IRC; Department of Pathology and Laboratory Medicine, Nova Scotia Health, Halifax, Nova Scotia, Canada.; Department of Pathology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.; Department of Medicine, Nova Scotia Health and Department of Medicine, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada., MacDonald T; Infection Prevention and Control, Nova Scotia Health, Halifax, Nova Scotia, Canada., Gaston D; Department of Pathology and Laboratory Medicine, Nova Scotia Health, Halifax, Nova Scotia, Canada.; Department of Pathology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada., LeBlanc JJ; Department of Pathology and Laboratory Medicine, Nova Scotia Health, Halifax, Nova Scotia, Canada.; Department of Pathology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.; Department of Medicine, Nova Scotia Health and Department of Medicine, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada., Shabi Y; Department of Pathology and Laboratory Medicine, Nova Scotia Health, Halifax, Nova Scotia, Canada.; Department of Pathology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada., Johnston BL; Department of Medicine, Nova Scotia Health and Department of Medicine, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
Jazyk:	angličtina
Zdroj:	Antimicrobial stewardship & healthcare epidemiology : ASHE [Antimicrob Steward Healthc Epidemiol] 2022 Sep 08; Vol. 2 (1), pp. e151. Date of Electronic Publication: 2022 Sep 08 (Print Publication: 2022).
DOI:	10.1017/ash.2022.288
Abstrakt:	Objective: To identify preventable factors that contribute to the cross transmission of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) to patients in healthcare facilities. Design: A case-control study was conducted among inpatients on a coronavirus disease 2019 (COVID-19) outbreak unit. Setting: This study was conducted in a medical-surgical unit of a tertiary-care hospital in Nova Scotia in May 2021. Patients: Patients hospitalized on the unit for at least 12 hours and healthcare workers (HCW) working on the unit within 2 weeks of outbreak declaration were included. Methods: Risk factors for SARS-CoV-2 infection were analyzed using simple and multiple logistic regression. Whole-genome sequencing (WGS) was performed to identify SARS-CoV-2 strain relatedness. Network analysis was used to describe patient accommodation. Results: SARS-CoV-2 infections were identified in 21 patients (29.6%) and 11 HCWs (6.6%). WGS data revealed 4 distinct clades of related sequences. Several factors likely contributed to the outbreak, including failure to identify SARS-CoV-2, a largely incomplete or unvaccinated population, and patient wandering behaviors. The most significant risk factor for SARS-CoV-2 infection was room sharing with an infectious patient, which was the only factor that remained statistically significant following multivariate analysis (odds ratio [OR], 9.2l; 95% confidence interval [CI], 2.04-41.67; P = .004). Conclusions: This outbreak likely resulted from admission of 2 patients with COVID-19, with subsequent transmissions to 17 patients and 11 staff. WGS and bioinformatics analyses were critical to identifying previously unrecognized nosocomial transmissions of SARS-CoV-2. This study supports strategies to reduce nosocomial transmissions of SARS-CoV-2, such as single-patient rooms, promotion of COVID-19 vaccination, and infection prevention and control measures including management of wandering behaviors. (© The Author(s) 2022.)
Databáze:	MEDLINE
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