COVID-19 in health-care workers in three hospitals in the south of the Netherlands: a cross-sectional study
COVID-19 in health-care workers in three hospitals in the south of the Netherlands: a cross-sectional study
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DOI：
10.1016/s1473-3099(20)30527-2
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发表时间：
2020-11-01
影响因子：
56.3
通讯作者：
Koopmans, Marion P. G.
中科院分区：
文献类型：
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作者：
Sikkema, Reina S.;Pas, Suzan D.;Koopmans, Marion P. G.
背景：在荷兰报告首例严重急性呼吸综合征冠状病毒2 （SARS-CoV-2）感染病例10天后（2020年2月27日），荷兰南部9家医院的1497名卫生保健工作者中有55人（4%）检测出SARS-CoV-2 RNA阳性。我们的目的是深入了解卫生保健工作者中可能的感染源。方法：我们在荷兰南部九家医院中的三家进行了横断面研究。我们根据筛查前10天的临床症状（发热或轻度呼吸道症状）对参与医院的医护人员进行SARS-CoV-2感染筛查。我们通过与卫生保健工作者的结构化访谈获得流行病学数据，并将这些信息与卫生保健工作者和患者临床样本中SARS-CoV-2全基因组测序数据相结合。我们对医护人员和患者中SARS-CoV-2的来源和传播方式进行了深入分析。在2020年3月2日至3月12日期间，对12022名卫生保健工作者进行了1796例（15%）筛查，其中96例（5%）检测为SARS-CoV-2阳性。我们从50名医护人员和10名患者中获得了完整和接近完整的基因组序列。大多数序列在三个粉尘中分组，其中两个簇在区域内显示局部循环。所注意到的模式与通过社区获得性感染和社区局部扩增而多次引入医院的情况一致。虽然不能排除医院内的直接传播，但我们的数据不支持广泛的医院传播作为患者或卫生保健工作者的感染源。版权所有(C) 2020作者。Elsevier Ltd.出版。
Background 10 days after the first reported case of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in the Netherlands (on Feb 27, 2020), 55 (4%) of 1497 health-care workers in nine hospitals located in the south of the Netherlands had tested positive for SARS-CoV-2 RNA. We aimed to gain insight in possible sources of infection in health-care workers.Methods We did a cross-sectional study at three of the nine hospitals located in the south of the Netherlands. We screened health-care workers at the participating hospitals for SARS-CoV-2 infection, based on clinical symptoms (fever or mild respiratory symptoms) in the 10 days before screening. We obtained epidemiological data through structured interviews with health-care workers and combined this information with data from whole-genome sequencing of SARS-CoV-2 in clinical samples taken from health-care workers and patients. We did an in-depth analysis of sources and modes of transmission of SARS-CoV-2 in health-care workers and patients.Findings Between March 2 and March 12, 2020, 1796 (15%) of 12022 health-care workers were screened, of whom 96 (5%) tested positive for SARS-CoV-2. We obtained complete and near-complete genome sequences from 50 healthcare workers and ten patients. Most sequences were grouped in three dusters, with two clusters showing local circulation within the region. The noted patterns were consistent with multiple introductions into the hospitals through community-acquired infections and local amplification in the community.Interpretation Although direct transmission in the hospitals cannot be ruled out, our data do not support widespread nosocomial transmission as the source of infection in patients or health-care workers. Copyright (C) 2020 The Author(s). Published by Elsevier Ltd.