SARS-CoV-2 burden on the floor was associated with COVID-19 cases and outbreaks in two acute care hospitals: a prospective cohort study.

Autor:	Fralick M; Division of General Internal Medicine, Sinai Health System, Toronto, ON, Canada.; Department of Medicine, University of Toronto, Toronto, ON, Canada.; Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON, Canada.; Sault Area Hospital, Sault Ste. Marie, ON, Canada., Moggridge JA; Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON, Canada., Wiebe M; Sault Area Hospital, Sault Ste. Marie, ON, Canada., Castellani L; Sault Area Hospital, Sault Ste. Marie, ON, Canada., McGeer A; Department of Microbiology, Sinai Health System, Toronto, ON, Canada.; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada., Feenstra B; The Ottawa Hospital, Ottawa, ON, Canada., Hinz A; Department of Biology, University of Ottawa, Ottawa, ON, Canada.; Department of Biology, McGill University, Montreal, QC, Canada., Hicks AMA; Department of Biology, University of Ottawa, Ottawa, ON, Canada.; Department of Biology, Carleton University, Ottawa, ON, Canada., Hug LA; Department of Biology, University of Waterloo, Waterloo, ON, Canada., Wong A; Department of Biology, Carleton University, Ottawa, ON, Canada., Van Bakel T; Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON, Canada., Abeygunawardena S; Division of General Internal Medicine, Sinai Health System, Toronto, ON, Canada.; Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON, Canada., Burhunduli T; CHEO Research Institute, Ottawa, ON, Canada., Mejbel HS; Department of Biology, University of Ottawa, Ottawa, ON, Canada., Kassen R; Department of Biology, University of Ottawa, Ottawa, ON, Canada.; Department of Biology, McGill University, Montreal, QC, Canada., Thampi N; CHEO Research Institute, Ottawa, ON, Canada., MacFadden D; The Ottawa Hospital Research Institute, Ottawa, ON, Canada., Nott C; The Ottawa Hospital, Ottawa, ON, Canada.; The Ottawa Hospital Research Institute, Ottawa, ON, Canada.
Jazyk:	angličtina
Zdroj:	Infection control and hospital epidemiology [Infect Control Hosp Epidemiol] 2024 Sep 20, pp. 1-5. Date of Electronic Publication: 2024 Sep 20.
DOI:	10.1017/ice.2024.121
Abstrakt:	Background: Recent work demonstrated that detection of SARS-CoV-2 on the floor of long-term care facilities is associated with impending COVID-19 outbreaks. It is unknown if similar results will be observed in hospitals. Methods: Floor swabs were prospectively collected weekly from healthcare worker-only areas (eg, staff locker rooms) at two hospitals in Ontario, Canada for 39 weeks. Floor swabs were processed for SARS-CoV-2 using quantitative reverse-transcriptase polymerase chain reaction. Results were reported as percentage of positive floor swabs and viral copy number. Grouped fivefold cross-validation was used to evaluate model outbreak discrimination. Results: SARS-CoV-2 RNA was detected on 537 of 760 floor swabs (71%). At Hospital A, overall positivity was 90% (95% CI: 85%-93%; N = 280); at Hospital B, overall positivity was 60% (95% CI: 55%-64%; N = 480). There were four COVID-19 outbreaks at Hospital A and seven at Hospital B during the study period. The outbreaks consisted of primarily patient cases (ie, 140 patient cases and 4 staff cases). For every 10-fold increase in viral copies, there was a 22-fold higher odds of a COVID-19 outbreak (OR = 22.0, 95% CI 7.3, 91.8). The cross-validated area under the receiver operating curve for SARS-CoV-2 viral copies for predicting a contemporaneous outbreak was 0.86 (95% CI 0.82-0.90). Conclusion: Viral burden of SARS-CoV-2 on floors, even in healthcare worker-only areas, was strongly associated with COVID-19 outbreaks in those hospital wards. Built environment sampling may support hospital COVID-19 outbreak identification, fill gaps in traditional surveillance, and guide infection prevention and control measures.
Databáze:	MEDLINE
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