Transmission of SARS-CoV-2 in Inpatient and Outpatient Settings in a Veterans Affairs Health Care System.
Transmission of SARS-CoV-2 in Inpatient and Outpatient Settings in a Veterans Affairs Health Care System.
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在退伍军人事务医疗系统中，在住院和门诊环境中传播SARS-COV-2。
DOI：
10.1093/ofid/ofab328
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发表时间：
2021-08
影响因子：
4.2
通讯作者：
Donskey CJ
中科院分区：
文献类型：
--
作者：
Jinadatha C;Jones LD;Choi H;Chatterjee P;Hwang M;Redmond SN;Navas ME;Zabarsky TF;Bhullar D;Cadnum JL;Donskey CJ
卫生保健人员和患者在卫生保健环境中，包括在门诊和辅助护理区域，面临感染严重急性呼吸综合征冠状病毒2(SARS-CoV-2)的风险。在2020年5月1日至2021年1月31日期间，我们确定了退伍军人事务部医疗保健系统中疑似医院传播的3例或更多冠状病毒病2019(新冠肺炎)病例。如果无症状的员工和患者通过接触者追踪调查被确定为有风险，则对他们进行SARS-CoV-2检测；对于7个集群，无论接触史如何，都对同一工作区域的所有人员和/或患者进行测试。进行全基因组测序，以确定来自集群以及来自对照员工和患者的SARS-CoV-2样本的相关性。在接受调查的14个联网中，7个发生在社区门诊，1个发生在急诊科，3个发生在辅助护理区，3个发生在医院内外科病房，这些病房没有为已知的新冠肺炎感染患者提供护理。82例有症状的新冠肺炎病例中81例(99%)和35例无症状病例中的31例(89%)发生在医护人员中。测序分析支持同事之间的几个传播事件，在2个案例中支持从卫生保健人员向患者传播。没有记录在案的从患者到人员的传播。医院内传播的新冠肺炎聚集性病例主要累及医护人员，多见于门诊和辅助保健区。需要改进措施，防止住院和门诊卫生保健人员传播SARS-CoV-2。
Health care personnel and patients are at risk to acquire severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in health care settings, including in outpatient clinics and ancillary care areas. Between May 1, 2020, and January 31, 2021, we identified clusters of 3 or more coronavirus disease 2019 (COVID-19) cases in which nosocomial transmission was suspected in a Veterans Affairs health care system. Asymptomatic employees and patients were tested for SARS-CoV-2 if they were identified as being at risk through contact tracing investigations; for 7 clusters, all personnel and/or patients in a shared work area were tested regardless of exposure history. Whole-genome sequencing was performed to determine the relatedness of SARS-CoV-2 samples from the clusters and from control employees and patients. Of 14 clusters investigated, 7 occurred in community-based outpatient clinics, 1 in the emergency department, 3 in ancillary care areas, and 3 on hospital medical/surgical wards that did not provide care for patients with known COVID-19 infection. Eighty-one of 82 (99%) symptomatic COVID-19 cases and 31 of 35 (89%) asymptomatic cases occurred in health care personnel. Sequencing analysis provided support for several transmission events between coworkers and in 2 cases supported transmission from health care personnel to patients. There were no documented transmissions from patients to personnel. Clusters of COVID-19 with nosocomial transmission predominantly involved health care personnel and often occurred in outpatient clinics and ancillary care areas. There is a need for improved measures to prevent transmission of SARS-CoV-2 by health care personnel in inpatient and outpatient settings.
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DOI：
10.1093/cid/ciab281
发表时间：
2021-09-15
期刊：
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
影响因子：
--
作者：
Braun KM;Moreno GK;Buys A;Somsen ED;Bobholz M;Accola MA;Anderson L;Rehrauer WM;Baker DA;Safdar N;Lepak AJ;O'Connor DH;Friedrich TC
通讯作者：
Friedrich TC
影响因子：
11.8
作者：
Maltezou, Helena C.;Dedoukou, Xanthi;Sipsas, Nikolaos
通讯作者：
Sipsas, Nikolaos
DOI：
10.1016/s1473-3099(20)30562-4
发表时间：
2020-11
期刊：
The Lancet. Infectious diseases
影响因子：
--
作者：
Meredith LW;Hamilton WL;Warne B;Houldcroft CJ;Hosmillo M;Jahun AS;Curran MD;Parmar S;Caller LG;Caddy SL;Khokhar FA;Yakovleva A;Hall G;Feltwell T;Forrest S;Sridhar S;Weekes MP;Baker S;Brown N;Moore E;Popay A;Roddick I;Reacher M;Gouliouris T;Peacock SJ;Dougan G;Török ME;Goodfellow I
通讯作者：
Goodfellow I
影响因子：
56.3
作者：
Sikkema, Reina S.;Pas, Suzan D.;Koopmans, Marion P. G.
通讯作者：
Koopmans, Marion P. G.
影响因子：
4.9
作者：
Zabarsky, Trina F.;Bhullar, Davinder;Donskey, Curtis J.
通讯作者：
Donskey, Curtis J.