Abstract
Objectives: Despite the quick implementation of infection prevention and control procedures and the use of personal protective equipment within healthcare facilities, many cases of nosocomial COVID-19 transmission have been reported. We aimed to estimate the frequency and impact of healthcare-associated COVID-19 (HA-COVID-19) and evaluate the contribution of whole-genome sequencing (WGS) in cluster investigation.
Methods: We estimated the frequency and mortality of HA-COVID-19 infections from September 1 to November 30, 2020, with a focus on the evolution of hospitalized community-associated COVID-19 (CA-COVID-19) cases and cases detected among healthcare workers (HCWs) within the Sorbonne University Hospital Group (Paris, France). We thoroughly examined 12 clusters through epidemiological investigations and WGS.
Results: Overall, 209 cases of HA-COVID-19 were reported. Evolution of HA-COVID-19 incidence closely correlated with the incidence of CA-COVID-19 and COVID-19 among HCWs. During the study period, 13.9 % of hospitalized patients with COVID-19 were infected in the hospital and the 30-day mortality rate of HA-COVID-19 was 31.5 %. Nosocomial transmission of SARS-CoV-2 led to clusters involving both patients and HCWs. WGS allowed the exclusion of one-third of cases initially assigned to a cluster.
Conclusions: WGS analysis combined with comprehensive epidemiological investigations is essential to understand transmission routes and adapt the IPC response to protect both patients and HCWs.
Keywords: Epidemiology; Healthcare-Associated infection; Infection control; Severe acute respiratory syndrome coronavirus 2; Whole genome sequencing.
【저자키워드】 severe acute respiratory syndrome coronavirus 2, infection control, Epidemiology, Healthcare-associated infection, whole genome sequencing., 【초록키워드】 COVID-19, severe acute respiratory syndrome coronavirus 2, whole-genome sequencing, Evolution, SARS-CoV-2, infection control, Personal protective equipment, coronavirus, Healthcare workers, Hospitalized, Mortality, hospital, Infection, Transmission, hospitalized patients, severe acute respiratory syndrome Coronavirus, healthcare worker, Whole genome sequencing, HCWs, healthcare, implementation, Patient, Infection prevention, Nosocomial transmission, Cluster, France, transmission route, epidemiological, incidence, WGS, group, university, Prevention and control, Transmission routes, Frequency, Analysis, acute respiratory syndrome, acute respiratory syndrome coronavirus, study period, Paris, exclusion, many cases, nosocomial COVID-19, 30-day mortality rate, PROTECT, were infected, evaluate, examined, reported, hospitalized patient, correlated, assigned, many case, with COVID-19, 【제목키워드】 COVID-19, hospital, investigation, French,