Abstract
Background: The COVID-19 pandemic poses a particularly high risk for End Stage Renal Disease (ESRD) patients so rapid identification of case clusters in ESRD facilities is essential. Nevertheless, with high community prevalence, a series of ESRD patients may test positive contemporaneously for reasons unrelated to their shared ESRD facility. Here we describe a series of 5 cases detected within 11 days in November 2020 in a hospital-based 32-station ESRD facility in Southwest Wisconsin, the subsequent facility-wide testing, and the use of genetic sequence analysis to evaluate links between cases.
Methods: Four patient cases and one staff case were identified in symptomatic individuals by RT-PCR. Facility-wide screening was conducted using rapid SARS-CoV-2 antigen tests. SARS-CoV-2 genome sequences were obtained from residual diagnostic specimens.
Results: Facility-wide screening of 47 staff and 107 patients identified no additional cases. Residual specimens from 4 of 5 cases were available for genetic sequencing. Clear genetic differences proved that these contemporaneous cases were not linked.
Conclusions: With high community prevalence, epidemiological data alone is insufficient to deem a case cluster an outbreak. Cluster evaluation with genomic data, when available with a short turn-around time, can play an important role in infection prevention and control response programs.
Keywords: COVID-19; End stage renal disease; Epidemiology; Genome sequencing; Infection prevention.
【저자키워드】 COVID-19, Epidemiology, Genome sequencing, Infection prevention, End stage renal disease, 【초록키워드】 COVID-19 pandemic, Sequencing, Genetic, diagnostic, RT-PCR, Prevalence, Genome sequencing, outbreak, Patient, Sequence analysis, Infection prevention, Community, Cluster, epidemiological data, SARS-CoV-2 antigen, renal disease, specimens, ESRD, Prevention and control, high risk, SARS-CoV-2 genome sequences, genomic data, specimen, symptomatic individuals, Stage, SARS-CoV-2 genome sequence, renal, positive, residual, evaluate, subsequent, conducted, End, genetic difference, symptomatic individual, 【제목키워드】 infection control, dialysis, SARS-CoV-2 sequencing,