Viral Sequencing to Investigate Sources of SARS-CoV-2 Infection in US Healthcare Personnel.
Viral Sequencing to Investigate Sources of SARS-CoV-2 Infection in US Healthcare Personnel.
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DOI：
10.1093/cid/ciab281
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发表时间：
2021-09-15
期刊：
影响因子：
--
通讯作者：
Friedrich TC
中科院分区：
文献类型：
--
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
医护人员感染严重急性呼吸综合征冠状病毒2(SARS-CoV-2)的风险增加。我们假设，目前的感染控制指南通常在医疗保健环境中保护HCP免受SARS-CoV-2感染。在这个回顾性病例系列中，我们使用病毒基因组学来调查2020年3月25日至12月27日期间美国中西部一家主要学术医疗机构HCP感染SARS-CoV-2的可能来源。我们通过非正式访谈和对电子健康记录的审查获得了有限的流行病学数据，并将这些信息与医疗保健相关的病毒序列和在更广泛的社区收集的病毒序列结合起来，以推断HCP最可能的感染源。我们调查了SARS-CoV-2感染集群，涉及95个HCP和137个可能的患者接触序列。大多数HCP感染与患者或同事无关(55/95，57.9%)，在基因上与社区内同时传播的病毒相似。我们发现，10.5%的HCP感染(10/95)可以追溯到同事。令人惊讶的是，只有4.2%(4/95)可以追溯到患者的来源。HCP之间的感染进一步增加了医疗系统的压力，并将患者、HCP和社区置于危险之中。我们在评估的大多数HCP感染中没有发现与医疗保健相关的传播证据。虽然我们不能排除与医疗保健相关的隐蔽传播的可能性，但似乎HCP最常见的是通过社区接触感染SARS-CoV-2。这强调了戴口罩、物理距离、强有力的检测计划和快速分发疫苗的持续重要性。95名医护人员(HCP)中大多数严重急性呼吸综合征冠状病毒(SARS-CoV-2)感染与患者或同事无关。始终如一地遵循感染控制程序，为护理SARS-CoV-2患者的HCP提供了重要保护。
Healthcare personnel (HCP) are at increased risk of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We posit that current infection control guidelines generally protect HCP from SARS-CoV-2 infection in a healthcare setting. In this retrospective case series, we used 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 and 27 December 2020. We obtained limited epidemiological data through informal interviews and review of the electronic health record and combined this information with healthcare-associated viral sequences and viral sequences collected in the broader community to infer the most likely source of infection in HCP. 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 coworker (55 of 95 [57.9%]) and were genetically similar to viruses circulating concurrently in the community. We found that 10.5% of HCP infections (10 of 95) could be traced to a coworker. Strikingly, only 4.2% (4 of 95) could be traced to a patient source. 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. Although we cannot rule out the possibility of cryptic healthcare-associated transmission, it appears that HCP most commonly become 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. The majority of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections in 95 healthcare personnel (HCP) could not be linked to a patient or coworker. Infection control procedures, consistently followed, offer significant protection to HCP caring for patients with SARS-CoV-2.
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影响因子：
82.9
作者：
Ladner, Jason T.;Grubaugh, Nathan D.;Andersen, Kristian G.
通讯作者：
Andersen, Kristian G.
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
DOI：
10.1093/infdis/jiy335
发表时间：
2018-09-22
期刊：
The Journal of infectious diseases
影响因子：
--
作者：
Houlihan CF;Frampton D;Ferns RB;Raffle J;Grant P;Reidy M;Hail L;Thomson K;Mattes F;Kozlakidis Z;Pillay D;Hayward A;Nastouli E
通讯作者：
Nastouli E
影响因子：
82.9
作者：
He, Xi;Lau, Eric H. Y.;Leung, Gabriel M.
通讯作者：
Leung, Gabriel M.
影响因子：
13.8
作者：
Jacob JT;Baker JM;Fridkin SK;Lopman BA;Steinberg JP;Christenson RH;King B;Leekha S;O'Hara LM;Rock P;Schrank GM;Hayden MK;Hota B;Lin MY;Stein BD;Caturegli P;Milstone AM;Rock C;Voskertchian A;Reddy SC;Harris AD
通讯作者：
Harris AD