Nosocomial Outbreak of SARS-CoV-2 in a "Non-COVID-19" Hospital Ward: Virus Genome Sequencing as a Key Tool to Understand Cryptic Transmission.
Nosocomial Outbreak of SARS-CoV-2 in a "Non-COVID-19" Hospital Ward: Virus Genome Sequencing as a Key Tool to Understand Cryptic Transmission.
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DOI：
10.3390/v13040604
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发表时间：
2021-04-01
期刊：
影响因子：
--
通讯作者：
Gomes JP
中科院分区：
文献类型：
--
作者：
Borges V;Isidro J;Macedo F;Neves J;Silva L;Paiva M;Barata J;Catarino J;Ciobanu L;Duarte S;Vieira L;Guiomar R;Gomes JP
严重急性呼吸综合征冠状病毒2(SARS-CoV-2)在医疗机构的传播影响到患者和卫生保健工作者以及提供基本卫生服务的机构能力。在这里，我们调查了一起暴发的SARS-CoV-2疫情，这起疫情发生在一家大规模检测揭开的“非新冠肺炎”医院病房，这对传播链条的重建提出了挑战。调查了筛查前15天内的接触网络，并对阳性的SARS-CoV-2 RNA样本进行了病毒基因组测序。在245名接受测试的个人中，48人(21名患者和27名卫生工作者)SARS-CoV-2检测呈阳性。医务人员大多无症状，但病死率达57.1%(12/21)。系统进化重建显示，所有病例都是同一传播链的一部分。通过结合接触者追踪和基因组数据，包括对新出现的微小变异的分析，我们揭示了SARS-CoV-2无声传播的情景，主要是由卫生工作者群体内以及卫生工作者与患者之间的密切接触推动的。这一调查引发了加强预防和控制措施，导致更及时地发现和遏制新的疫情。这项研究显示了结合基因组和流行病学数据在揭示复杂的医院暴发方面的好处，并为防止新冠肺炎在医疗机构中的传播提供了宝贵的数据。
Dissemination of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in healthcare institutions affects both patients and health-care workers (HCW), as well as the institutional capacity to provide essential health services. Here, we investigated an outbreak of SARS-CoV-2 in a “non-COVID-19” hospital ward unveiled by massive testing, which challenged the reconstruction of transmission chains. The contacts network during the 15-day period before the screening was investigated, and positive SARS-CoV-2 RNA samples were subjected to virus genome sequencing. Of the 245 tested individuals, 48 (21 patients and 27 HCWs) tested positive for SARS-CoV-2. HCWs were mostly asymptomatic, but the mortality among patients reached 57.1% (12/21). Phylogenetic reconstruction revealed that all cases were part of the same transmission chain. By combining contact tracing and genomic data, including analysis of emerging minor variants, we unveiled a scenario of silent SARS-CoV-2 dissemination, mostly driven by the close contact within the HCWs group and between HCWs and patients. This investigation triggered enhanced prevention and control measures, leading to more timely detection and containment of novel outbreaks. This study shows the benefit of combining genomic and epidemiological data for disclosing complex nosocomial outbreaks, and provides valuable data to prevent transmission of COVID-19 in healthcare facilities.
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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：
11.8
作者：
Rickman, Hannah M.;Rampling, Tommy;Houlihan, Catherine F.
通讯作者：
Houlihan, Catherine F.
中国武汉市院内爆发 COVID-19 肺炎
影响因子：
24.3
作者：
Wang, Xiaorong;Zhou, Qiong;Gao, Zhancheng
通讯作者：
Gao, Zhancheng
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：
7.7
作者：
Rivett, Lucy;Sridhar, Sushmita;Weekes, Michael P.
通讯作者：
Weekes, Michael P.