Norovirus outbreaks in long-term care facilities in Catalonia from 2017 to 2018

AbstractNorovirus is the leading cause of outbreaks of acute viral gastroenteritis. We carried out this study to investigate outbreaks in long-term care facilities reported in 2017 and 2018 in Catalonia (Spain). The characteristics of the centers, exposed persons and the genogroups responsible were analyzed. Viral loads were estimated. The attack rate (AR) of the outbreaks studied, and the rate ratio (RR) and the odds ratio (OR) and their 95% confidence intervals as measures of association were calculated. The mean cycle thresholds were compared using the t-test for independent means. We included 30 outbreaks (4631 exposed people). The global AR was 25.93%. The RR of residents vs. staff was 2.28 (95% CI 2.0–2.6). The RR between AR in residents with total or severe dependence vs. residents with moderate, low or no-dependence was 1.23 (95% CI 1.05–1.45). The AR were higher in smaller centers than in larger ones (38.47% vs. 19.25% and RR 2; 95% CI 1.82–2.2). GII was responsible for 70% of outbreaks. No association was found between the genogroup and presenting symptoms (OR 0.96; 95% CI 0.41–2.26). Viral loads were higher in symptomatic than in asymptomatic patients (p = 0.001).

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Norovirus outbreaks in long-term care facilities. Catalonia, 2017-2018

10.21203/rs.3.rs-240186/v1 ◽

2021 ◽

Author(s):

Ignacio Parrón ◽

Irene Barrabeig ◽

Miquel Alseda ◽

Cristina Rius ◽

Thais Cornejo-Sánchez ◽

...

Keyword(s):

Attack Rate ◽

Long Term Care ◽

Control Measures ◽

Viral Gastroenteritis ◽

Term Care ◽

Viral Loads ◽

Presenting Symptoms ◽

Asymptomatic Patients ◽

Care Facilities

Abstract Norovirus is the leading cause of outbreaks of acute viral gastroenteritis. We carried out this study to investigate outbreaks in long-term care facilities reported in 2017 and 2018 in Catalonia (Spain). The characteristics of the centres, exposed persons and the genogroups responsible were analyzed. Viral loads were estimated. The attack rate (AR), rate ratios (RR) or the odds ratio (OR) and its 95% confidence intervals were calculated. The mean cycle thresholds (Cq) were compared using the t-test for independent means. We included 30 outbreaks (4,631 exposed people). The global AR was 25.9%. The RR of residents vs. staff was 2.28 (95%CI 2.0-2.6). In residents with total or severe dependence the attack rate was 85.16% and in residents with moderate and low dependence or independent was 69.13% (RR 1.23, 95% CI 1.05–1.45). ARs were higher in smaller centres than in larger ones (34.4% vs 19.5%; RR 1.76 (95%CI 1.60–1.94). GII was responsible for 70% of outbreaks and 78.5% of identifications. No association was found between the genogroup and presenting symptoms (OR 0.96; 95% CI 0.41 to 2.26). Viral loads were higher in symptomatic than in asymptomatic patients (p = 0.001). Because norovirus was detected in asymptomatic persons, control measures should be applied not only to people with symptoms but to all persons in LTCF where norovirus outbreaks occur.

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Acquisition of Clostridium difficile Colonization and Infection After Transfer From a Veterans Affairs Hospital to an Affiliated Long-Term Care Facility

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2017.140 ◽

2017 ◽

Vol 38 (9) ◽

pp. 1070-1076 ◽

Cited By ~ 13

Author(s):

Suresh Ponnada ◽

Dubert M. Guerrero ◽

Lucy A. Jury ◽

Michelle M. Nerandzic ◽

Jennifer L. Cadnum ◽

...

Keyword(s):

Clostridium Difficile ◽

Long Term Care ◽

Care Facility ◽

Veterans Affairs ◽

Term Care ◽

Long Term Care Facility ◽

Asymptomatic Patients ◽

Care Facilities

BACKGROUNDClostridium difficile infection (CDI) and asymptomatic carriage of toxigenic C. difficile are common in long-term care facilities (LTCFs). However, whether C. difficile is frequently acquired in the LTCF versus during acute-care admissions remains unknown.OBJECTIVETo test the hypothesis that LTCF residents often acquire C. difficile colonization and infection in the LTCFDESIGNThis 5-month cohort study was conducted to determine the incidence of acquisition of C. difficile colonization and infection in asymptomatic patients transferred from a Veterans Affairs hospital to an affiliated LTCF.METHODSRectal swabs were cultured for toxigenic C. difficile at the time of transfer to the LTCF and weekly for up to 6 weeks. We calculated the proportion of LTCF-onset CDI cases within 1 month of transfer that occurred in residents colonized on admission versus those with new acquisition in the LTCF.RESULTSOf 110 patients transferred to the LTCF, 12 (11%) were asymptomatically colonized with toxigenic C. difficile upon admission, and 4 of these 12 patients (33%) developed CDI within 1 month, including 3 recurrent and 1 initial CDI episode. Of 82 patients with negative cultures on transfer and at least 1 follow-up culture, 22 (27%) acquired toxigenic C. difficile colonization, and 4 developed CDI within 1 month, including 1 recurrent and 3 initial CDI episodes.CONCLUSIONLTCF residents frequently acquired colonization with toxigenic C. difficile after transfer from the hospital, and 3 of 4 initial CDI cases with onset within 1 month of transfer occurred in residents who acquired colonization in the LTCF.Infect Control Hosp Epidemiol 2017;38:1070–1076

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