scholarly journals In depth characterization of vaccine breakthrough infections with SARS-CoV-2 among healthcare workers of a Dutch academic medical center

2021 ◽  
Author(s):  
Lidewij W Rümke ◽  
Femke C Groenveld ◽  
Yvonne M G van Os ◽  
Patrique Praest ◽  
Anniek A N Tanja ◽  
...  
Keyword(s):  
Immune Responses ◽  
Healthcare Workers ◽  
Medical Center ◽  
Academic Medical Center ◽  
Risk Exposure ◽  
Live Virus ◽  
Viral Loads ◽  
Academic Medical ◽  
T Cell Immune Responses

Abstract SARS-CoV-2 infection after COVID-19 vaccination raises concerns about the emergence of vaccine escape variants. Here we characterize 14 breakthrough infections among 5860 fully vaccinated Dutch healthcare workers ≥14 days post final dose of vaccination with either BNT162b2, mRNA-1273 or Ad26.COV2.S. These breakthrough infections presented with regular B.1.1.7 (Alpha) and B.1.617.2 (Delta) variants and high viral loads, despite normal vaccine induced B- and T-cell immune responses detected by live virus neutralization assays and ELISpot. High-risk exposure settings, such as in households, indicate a potential risk of viral transmission despite full vaccination.

scholarly journals 421. Effect of SARs-Cov-2 mRNA Vaccination in Healthcare Workers with Household COVID Exposure

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S311-S311
Author(s):  
Laura Selby ◽  
Richard Starlin
Keyword(s):  
Healthcare Workers ◽  
Screening Program ◽  
Medical Center ◽  
Severe Disease ◽  
Academic Medical Center ◽  
Tertiary Care ◽  
Limited Data ◽  
Viral Shedding ◽  
Academic Medical ◽  
Significant Burden

Abstract Background Healthcare workers have experienced a significant burden of COVID-19 disease. COVID mRNA vaccines have shown great efficacy in prevention of severe disease and hospitalization due to COVID infection, but limited data is available about acquisition of infection and asymptomatic viral shedding. Methods Fully vaccinated healthcare workers at a tertiary-care academic medical center in Omaha Nebraska who reported a household exposure to COVID-19 infection are eligible for a screening program in which they are serially screened with PCR but allowed to work if negative on initial test and asymptomatic. Serial screening by NP swab was completed every 5-7 days, and workers became excluded from work if testing was positive or became symptomatic. Results Of the 94 employees who were fully vaccinated at the time of the household exposure to COVID-19 infection, 78 completed serial testing and were negative. Sixteen were positive on initial or subsequent screening. Vaccine failure rate of 17.0% (16/94). Healthcare workers exposed to household COVID positive contact Conclusion High risk household exposures to COVID-19 infection remains a significant potential source of infections in healthcare workers even after workers are fully vaccinated with COVID mRNA vaccines especially those with contact to positive domestic partners. Disclosures All Authors: No reported disclosures

scholarly journals The Epidemiology of Methicillin-ResistantStaphylococcus aureuson a Burn Trauma Unit

2012 ◽  
Vol 33 (11) ◽  
pp. 1118-1125 ◽  
Author(s):  
Marin Schweizer ◽  
Melissa Ward ◽  
Sandra Cobb ◽  
Jennifer McDanel ◽  
Laurie Leder ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Medical Center ◽  
Academic Medical Center ◽  
Nasal Carriage ◽  
Burn Trauma ◽  
Trauma Unit ◽  
Time Period ◽  
Academic Medical ◽  
A Site ◽  
Mrsa Colonization

Objective.We assessed the frequency and relatedness of methicillin-resistantStaphylococcus aureus(MRSA) isolates to determine whether healthcare workers, the environment, or admitted patients could be a reservoir for MRSA on a burn trauma unit (BTU). We also assessed risk factors for MRSA colonization among BTU patients.Design.Prospective cohort study and surveillance for MRSA carriage.Setting.BTU of a Midwestern academic medical center.Patients and Participants.Patients admitted to a BTU from February 2009 through January 2010 and healthcare workers on this unit during the same time period.Methods.Samples for MRSA culture were collected on admission from the nares and wounds of all BTU patients. We also had collected culture samples from the throat, axilla, antecubital fossa, groin, and perianal area of 12 patients per month. Samples collected from healthcare workers' nares and from environmental sites were cultured quarterly. MRSA isolates were typed by pulsed-field gel electrophoresis.Results.Of 144 patients, 24 (17%) carried MRSA in their nares on admission. Male sex (odds ratio [OR], 5.51; 95% confidence interval [95% CI], 1.25–24.30), admission for necrotizing fasciitis (OR, 7.66; 95% CI, 1.64–35.81), and MRSA colonization of a site other than the nares (OR, 23.40; 95% CI, 6.93–79.01) were independent predictors of MRSA nasal carriage. Cultures of samples collected from 4 healthcare workers and 4 environmental cultures had positive results. Two patients were colonized with strains that were indistinguishable from strains collected from a healthcare worker or the environment.Conclusions.Patients were a major reservoir for MRSA. Infection control efforts should focus on preventing transmission of MRSA from patients who are MRSA carriers to other patients on the unit.

Characterization of Familial Hypercholesterolemia Management at an Academic Medical Center*

2019 ◽  
Vol 13 (3) ◽  
pp. e39-e40
Author(s):  
Danielle Hess ◽  
Stephanie Seto ◽  
Pramit Nadpara ◽  
Evan Sisson ◽  
Dave Dixon
Keyword(s):  
Familial Hypercholesterolemia ◽  
Medical Center ◽  
Academic Medical Center ◽  
Academic Medical

scholarly journals 565. Risk of COVID-19 Among Healthcare Workers After Launch of Vaccination Campaign at an Academic Medical Center

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S384-S385
Author(s):  
Bhagyashri D Navalkele ◽  
Jose Lucar ◽  
James B Brock ◽  
Jason Parham
Keyword(s):  
Healthcare Workers ◽  
Medical Center ◽  
Severe Disease ◽  
Vaccination Campaign ◽  
Academic Medical Center ◽  
Complete Recovery ◽  
Healthcare Facility ◽  
Asymptomatic Infection ◽  
Academic Medical ◽  
The Impact

Abstract Background Coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 virus affected healthcare workers (HCWs) adding additional burden on staffing shortages. COVID-19 vaccination (mRNA 1273 and BNT162b2) has been shown to protect against severe disease, death and reduced risk of asymptomatic infection and transmission from fully vaccinated individuals. Here, we present the impact of COVID-19 vaccination (CoVac) on risk of developing COVID-19 based on test results among unvaccinated and vaccinated HCWs. Methods Our academic medical center with 11,785 HCWs on its Jackson campus initiated non-mandatory CoVac among HCWs with BNT162b2 on December 16, 2020. Individuals ≥ 2 weeks after 1st dose of vaccine were defined as partially vaccinated and those ≥2 weeks from 2nd dose of vaccine were defined as fully vaccinated. Per facility policy, all symptomatic HCWs (irrespective of vaccination status) were recommended to undergo SARS-CoV-2 RT-PCR testing. Asymptomatic HCWs were also tested upon household exposure, however, this policy was changed on March 9th 2021 to allow fully vaccinated asymptomatic HCWs to work without need for quarantine or testing. Universal masking policy among HCWs remained effective at our center during study period. Results Between the launch of COVID-19 vaccination on December 16, 2020 and April 30, 2021, 5,855 HCWs received one dose of vaccine, and 5,687 received both doses. A total of 1,329 unique HCWs underwent COVID-19 testing between January 4, 2021 and April 30, 2021. Of those, 217 (16.3%) tested positive for SARS-CoV-2 infection; 204 were unvaccinated, 7 were partially vaccinated, and 6 were fully vaccinated (figure 1). Of the 6 fully vaccinated employees, 1 was asymptomatic (testing for travel purposes), 4 had mild symptoms, and one elderly employee required hospitalization with oxygen supplementation and had a complete recovery. No facility outbreaks were reported related to asymptomatic, work exposed, fully vaccinated HCWs. Unvaccinated healthcare workers were more likely to test positive for SARS-CoV-2 compared to partially and fully vaccinated healthcare workers. Conclusion COVID-19 vaccination protected HCWs by reducing risk for developing COVID-19. Vaccinating healthcare workers is a crucial infection prevention measure to reduce disease burden, avoid staffing shortages and create a safe environment in the healthcare facility to prevent transmission to other staff and at-risk patients. Disclosures All Authors: No reported disclosures

scholarly journals COVID-19 screening system utilizing daily symptom attestation helps identify hospital employees who should be tested to protect patients and co-workers

2021 ◽  
pp. 1-17
Author(s):  
Ellen Kim ◽  
Charles Morris ◽  
Michael Klompas ◽  
Haipeng Zhang ◽  
Adam Landman ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Data Linkage ◽  
Medical Center ◽  
Academic Medical Center ◽  
Health Records ◽  
Hospital Employees ◽  
Runny Nose ◽  
Symptom Screening ◽  
Academic Medical ◽  
Chi Squared

ABSTRACT Objective: To investigate the effectiveness of a daily attestation system used by employees of a multi-institutional academic medical center, which comprised of symptom-screening, self-referrals to the Occupational Health team, and/or a COVID-19 test. Design: Retrospective cohort study of all employee attestations and COVID-19 tests performed between March and June 2020. Setting: A large multi-institutional academic medical center, including both inpatient and ambulatory settings. Participants: All employees who worked at the study site. Methods: Data was combined from the attestation system (COVIDPass), the employee database, and the electronic health records, and was analyzed using descriptive statistics including chi-squared, Wilcoxon, and Kruskal-Wallis tests. We investigated whether an association existed between symptomatic attestations by the employees and them testing positive for COVID-19. Results: After data linkage and cleaning, there were 2,117,298 attestations submitted by 65,422 employees between March and June 2020. Most attestations were asymptomatic (99.9%). The most commonly reported symptoms were sore throat (910), runny nose (637), and cough (570). Of the 2,026 employees who ever attested symptomatic, 905 employees were tested within 14 days of a symptomatic attestation, and 114 (13%) of these tests were positive. The most common symptoms associated with a positive COVID-19 test were anosmia (23% vs 4%) and fever (46% vs 19%). Conclusions: Daily symptom attestations amongst healthcare workers identified a handful of employees with Covid-19. While the number of positives was low, attestations may help keep unwell employees off campus to try to prevent transmissions.

High-Throughput Molecular Analysis of Pseudohypoparathyroidism 1b Patients Reveals Novel Genetic and Epigenetic Defects

2021 ◽  
Author(s):  
Jennifer Danzig ◽  
Dong Li ◽  
Suzanne Jan de Beur ◽  
Michael A Levine
Keyword(s):  
Haplotype Analysis ◽  
Medical Center ◽  
Academic Medical Center ◽  
Uniparental Disomy ◽  
Healthy Individuals ◽  
Microsatellite Haplotype ◽  
Academic Medical ◽  
Sporadic Cases ◽  
Methylation Defects

Abstract Context Patients with pseudohypoparathyroidism type 1b (PHP1b) show disordered imprinting of the maternal GNAS allele or paternal uniparental disomy (UPD). Genetic deletions in STX16 or in upstream exons of GNAS are present in many familial but not sporadic cases. Objective Characterization of epigenetic and genetic defects in patients with PHP1b. Design and Patients DNA from 84 subjects, including 26 subjects with sporadic PHP1b, 27 affected subjects and 17 unaffected and/or obligate gene carriers from 12 PHP1b families, 11 healthy individuals, and 3 subjects with PHP1a was subjected to quantitative pyrosequencing of GNAS differentially methylated regions (DMRs), microarray analysis, and microsatellite haplotype analysis. Setting Academic medical center. Main Outcome Measurements Molecular pathology of PHP1b. Results Healthy subjects, unaffected family members and obligate carriers of paternal PHP1b alleles, and subjects with PHP1a showed normal methylation of all DMRs. All PHP1b subjects showed loss of methylation (LOM) at the exon A/B DMR. Affected members of nine PHP1b kindreds showed LOM only at the exon A/B DMR, which was associated with a 3-kb deletion of STX16 exons 4-6 in seven families and a novel deletion of STX16 and adjacent NEPEPL1 in one family. A novel NESP deletion was found in one of two other families with more extensive methylation defects. One sporadic PHP1b had UPD of 20q, two had 3-kb STX16 deletions, and five had apparent epigenetic mosaicism. Conclusions We found diverse patterns of defective methylation and identified novel or previously known mutations in 9 of 12 PHP1b families.

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