tetano
Editor, Senior Moderator
Clin Infect Dis
. 2021 Apr 15;ciab281.
doi: 10.1093/cid/ciab281. Online ahead of print.
Viral sequencing reveals US healthcare personnel rarely become infected with SARS-CoV-2 through patient contact
Katarina M Braun[SUP] 1 [/SUP], Gage K Moreno[SUP] 2 [/SUP], Ashley Buys[SUP] 3 [/SUP], Elizabeth D Somsen[SUP] 2 [/SUP], Max Bobholz[SUP] 2 [/SUP], Molly A Accola[SUP] 3 [/SUP], Laura Anderson[SUP] 3 [/SUP], William M Rehrauer[SUP] 3 [/SUP], David A Baker[SUP] 2 [/SUP], Nasia Safdar[SUP] 4 [/SUP], Alexander J Lepak[SUP] 4 [/SUP], David H O'Connor[SUP] 2 5 [/SUP], Thomas C Friedrich[SUP] 1 5 [/SUP]
Affiliations
Abstract
Background: Healthcare personnel (HCP) are at increased risk of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We posit current infection control guidelines generally protect HCP from SARS-CoV-2 infection in a healthcare setting.
Methods: In this retrospective case series, we use viral genomics to investigate the likely source of SARS-CoV-2 infection in HCP at a major academic medical institution in the Upper Midwest of the United States between 25 March - 27 December, 2020. We obtain limited epidemiological data through informal interviews and review of the electronic health record. We combine epidemiological information with healthcare-associated viral sequences and with viral sequences collected in the broader community to infer the most likely source of infection in HCP.
Results: We investigated SARS-CoV-2 infection clusters involving 95 HCP and 137 possible patient contact sequences. The majority of HCP infections could not be linked to a patient or co-worker (55/95; 57.9%) and were genetically similar to viruses circulating concurrently in the community. We found 10.5% of infections could be traced to a coworker (10/95). Strikingly, only 4.2% of HCP infections could be traced to a patient source (4/95).
Conclusions: Infections among HCP add further strain to the healthcare system and put patients, HCP, and communities at risk. We found no evidence for healthcare-associated transmission in the majority of HCP infections evaluated here. Though we cannot rule out the possibility of cryptic healthcare-associated transmission, it appears that HCP most commonly becomes infected with SARS-CoV-2 via community exposure. This emphasizes the ongoing importance of mask-wearing, physical distancing, robust testing programs, and rapid distribution of vaccines.
. 2021 Apr 15;ciab281.
doi: 10.1093/cid/ciab281. Online ahead of print.
Viral sequencing reveals US healthcare personnel rarely become infected with SARS-CoV-2 through patient contact
Katarina M Braun[SUP] 1 [/SUP], Gage K Moreno[SUP] 2 [/SUP], Ashley Buys[SUP] 3 [/SUP], Elizabeth D Somsen[SUP] 2 [/SUP], Max Bobholz[SUP] 2 [/SUP], Molly A Accola[SUP] 3 [/SUP], Laura Anderson[SUP] 3 [/SUP], William M Rehrauer[SUP] 3 [/SUP], David A Baker[SUP] 2 [/SUP], Nasia Safdar[SUP] 4 [/SUP], Alexander J Lepak[SUP] 4 [/SUP], David H O'Connor[SUP] 2 5 [/SUP], Thomas C Friedrich[SUP] 1 5 [/SUP]
Affiliations
- PMID: 33857303
- DOI: 10.1093/cid/ciab281
Abstract
Background: Healthcare personnel (HCP) are at increased risk of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We posit current infection control guidelines generally protect HCP from SARS-CoV-2 infection in a healthcare setting.
Methods: In this retrospective case series, we use viral genomics to investigate the likely source of SARS-CoV-2 infection in HCP at a major academic medical institution in the Upper Midwest of the United States between 25 March - 27 December, 2020. We obtain limited epidemiological data through informal interviews and review of the electronic health record. We combine epidemiological information with healthcare-associated viral sequences and with viral sequences collected in the broader community to infer the most likely source of infection in HCP.
Results: We investigated SARS-CoV-2 infection clusters involving 95 HCP and 137 possible patient contact sequences. The majority of HCP infections could not be linked to a patient or co-worker (55/95; 57.9%) and were genetically similar to viruses circulating concurrently in the community. We found 10.5% of infections could be traced to a coworker (10/95). Strikingly, only 4.2% of HCP infections could be traced to a patient source (4/95).
Conclusions: Infections among HCP add further strain to the healthcare system and put patients, HCP, and communities at risk. We found no evidence for healthcare-associated transmission in the majority of HCP infections evaluated here. Though we cannot rule out the possibility of cryptic healthcare-associated transmission, it appears that HCP most commonly becomes infected with SARS-CoV-2 via community exposure. This emphasizes the ongoing importance of mask-wearing, physical distancing, robust testing programs, and rapid distribution of vaccines.