scholarly journals Risk of SARS-CoV-2 exposure among hospital healthcare workers in relation to patient contact and type of care

Author(s):  
Susanna Klevebro ◽  
Fuad Bahram ◽  
K. Miriam Elfström ◽  
Ulrika Hellberg ◽  
Sophia Hober ◽  
...  

AbstractAimWe aimed to assess the risk for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection in a large cohort of healthcare workers (HCWs).MethodsFrom May 11 until June 11, 2020, 3,981 HCWs at a large Swedish Emergency Care hospital provided serum samples and questionnaire data. Exposure was measured by assaying IgG antibodies to SARS-CoV-2.ResultsThe total seroprevalence was 17.7% and increased during the study period. Among the seropositive HCWs, 10.5% had been entirely asymptomatic. Participants who worked with COVID-19 patients had higher odds for seropositivity: ORadj 1.96 (95% CI 1.59 – 2.42). HCWs from three of the departments managing COVID-19 patients had significantly higher seroprevalences, whereas the prevalence among HCWs from the Intensive Care Unit (also managing COVID-19 patients) was significantly lower.ConclusionHCWs in contact with SARS-CoV-2 infected patients had a variable, but on average higher, likelihood for SARS-CoV-2 infections.

2021 ◽  
pp. 140349482110224
Author(s):  
Susanna Klevebro ◽  
Fuad Bahram ◽  
K. Miriam Elfström ◽  
Ulrika Hellberg ◽  
Sophia Hober ◽  
...  

Aim: We aimed to assess prevalence of IgG antibodies to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and factors associated with seropositivity in a large cohort of healthcare workers (HCWs). Methods: From 11 May until 11 June 2020, 3981 HCWs at a large Swedish emergency care hospital provided serum samples and questionnaire data. Presence of IgG antibodies to SARS-CoV-2 was measured as an indicator of SARS-CoV-2 exposure. Results: The total seroprevalence was 18% and increased during the study period. Among the seropositive HCWs, 11% had been entirely asymptomatic. Participants who worked with COVID-19 patients had higher odds for seropositivity: adjusted odds ratio 1.96 (95% confidence intervals 1.59–2.42). HCWs from three of the departments managing COVID-19 patients had significantly higher seroprevalences, whereas the prevalence among HCWs from the intensive care unit (also managing COVID-19 patients) was significantly lower. Conclusions: HCWs in contact with SARS-CoV-2 infected patients had a variable, but on average higher, likelihood for SARS-CoV-2 infections.


2019 ◽  
Author(s):  
Dikeledi Carol Sebola ◽  
Charlie Boucher ◽  
Caroline Maslo ◽  
Daniel Nenene Qekwana

Abstract Hand hygiene compliance remains the cornerstone of infection prevention and control (IPC) in healthcare facilities. However, there is a paucity of information on the level of IPC in veterinary health care facilities in South Africa. Therefore, this study evaluated hand hygiene compliance of healthcare workers and visitors in the intensive care unit (ICU) at the Onderstepoort Veterinary Academic Hospital (OVAH). Method: A cross-sectional study was conducted among healthcare workers (HCWs) and visitors in the ICU using the infection control assessment tool (ICAT) as stipulated by the South African National Department of Health. Direct observations using the “five hand hygiene moments” criteria as set out by the World helath Organisation were also recorded. The level of compliance and a 95% confidence interval were calculated for all variables. Results: Individual bottles of alcohol-based hand-rub solution and hand-wash basins with running water, soap dispensers, and paper towels were easily accessible and available at all times in the ICU. In total, 296 observations consisting of 734 hand hygiene opportunities were recorded. Hand hygiene compliance was also evaluated during invasive (51.4%) and non-invasive (48.6%) procedures. The overall hand hygiene compliance was 24.3% (178/734). In between patients, most HCWs did not sanitize stethoscopes, leashes, and cellular phones used. Additionally, the majority of HCWs wore jewellery below the elbows. The most common method of hand hygiene was hand-rub (58.4%), followed by hand-wash (41.6%). Nurses had a higher (44%) level of compliance compared to students (22%) and clinicians (15%). Compliance was also higher after body fluid exposure (42%) compared to after patient contact (32%), before patient contact (19%), after contact with patient surroundings (16%), and before an aseptic procedure (15%). Conclusion: Hand hygiene compliance in this study was low, raising concerns of potential transmission of hospital-acquired infections and zoonoses in the ICU. Therefore, it is essential that educational programs be developed to address the low level of hand hygiene in this study.


2020 ◽  
Vol 11 (1) ◽  
Author(s):  
Ann-Sofie Rudberg ◽  
Sebastian Havervall ◽  
Anna Månberg ◽  
August Jernbom Falk ◽  
Katherina Aguilera ◽  
...  

Abstract SARS-CoV-2 may pose an occupational health risk to healthcare workers. Here, we report the seroprevalence of SARS-CoV-2 antibodies, self-reported symptoms and occupational exposure to SARS-CoV-2 among healthcare workers at a large acute care hospital in Sweden. The seroprevalence of IgG antibodies against SARS-CoV-2 was 19.1% among the 2149 healthcare workers recruited between April 14th and May 8th 2020, which was higher than the reported regional seroprevalence during the same time period. Symptoms associated with seroprevalence were anosmia (odds ratio (OR) 28.4, 95% CI 20.6–39.5) and ageusia (OR 19.2, 95% CI 14.3–26.1). Seroprevalence was also associated with patient contact (OR 2.9, 95% CI 1.9–4.5) and covid-19 patient contact (OR 3.3, 95% CI 2.2–5.3). These findings imply an occupational risk for SARS-CoV-2 infection among healthcare workers. Continued measures are warranted to assure healthcare workers safety and reduce transmission from healthcare workers to patients and to the community.


Author(s):  
Kinjal Patel ◽  
Suraj Purusottaman ◽  
Trupti Carval ◽  
Lekhan Narvekar

Background: Infection control practices played a major role in prevention of SARS-CoV-2 in healthcare settings. Aim of the study was to know the compliance to infection control and prevention practices by healthcare workers in COVID-19 pandemic and the measures taken for prevention of SARS-CoV-2 spread in the hospital.Methods: An observational study was conducted at tertiary care hospital for a period of one month. All healthcare workers involved in patient care of COVID-19 and non COVID-19 was observed for their infection control practices. Areas were divided in two category, intensive care unit and indoor wards for audit. Environmental samples of various surfaces from intensive care unit and wards were taken and analyzed for the presence of SARS-CoV-2 RNA by reverse transcriptase polymerase chain reaction.Results: Overall compliance to infection prevention practices were improved during pandemic. Hand hygiene compliance in intensive care unit and indoor wards of COVID-19 unit were 78.66% and 74.36% whilst in non COVID-19 units was 72.47% and 62.31% respectively. Compliance to revised biomedical waste (BMW) policy at COVID-19 unit were 85.20% and 71.49% in intensive care unit and ward respectively. However, at non COVID-19 unit, it was 65.22% and 57.60%. Nursing station and doffing area of ICU at non-COVID-19 unit showed presence of SARS-CoV-2 virus. While all samples collected from COVID-19 unit were negative.Conclusions: Infection prevention and control practices play a key role to curtail transmission of infection. Awareness among healthcare workers, hospital environment, and usage of personal protective equipment should be optimized even at non COVID-19 facility.


2014 ◽  
Vol 35 (3) ◽  
pp. 225-230 ◽  
Author(s):  
Laura Goodliffe ◽  
Kelsey Ragan ◽  
Michael Larocque ◽  
Emily Borgundvaag ◽  
Sophia Khan ◽  
...  

Objective.Identify factors affecting the rate of hand hygiene opportunities in an acute care hospital.Design.Prospective observational study.Setting.Medical and surgical in-patient units, medical-surgical intensive care unit (MSICU), neonatal intensive care unit (NICU), and emergency department (ED) of an academic acute care hospital from May to August, 2012.Participants.Healthcare workers.Methods.One-hour patient-based observations measured patient interactions and hand hygiene opportunities as defined by the “Four Moments for Hand Hygiene.” Rates of patient interactions and hand hygiene opportunities per patient-hour were calculated, examining variation by room type, healthcare worker type, and time of day.Results.During 257 hours of observation, 948 healthcare worker-patient interactions and 1,605 hand hygiene opportunities were identified. Moments 1, 2, 3, and 4 comprised 42%, 10%, 9%, and 39% of hand hygiene opportunities. Nurses contributed 77% of opportunities, physicians contributed 8%, other healthcare workers contributed 11%, and housekeeping contributed 4%. The mean rate of hand hygiene opportunities per patient-hour was 4.2 for surgical units, 4.5 for medical units, 5.2 for ED, 10.4 for NICU, and 13.2 for MSICU (P < .001). In non-ICU settings, rates of hand hygiene opportunities decreased over the course of the day. Patients with transmission-based precautions had approximately half as many interactions (rate ratio [RR], 0.55 [95% confidence interval (CI), 0.37-0.80]) and hand hygiene opportunities per hour (RR, 0.47 [95% CI, 0.29-0.77]) as did patients without precautions.Conclusions.Measuring hand hygiene opportunities across clinical settings lays the groundwork for product use-based hand hygiene measurement. Additional work is needed to assess factors affecting rates in other hospitals and health care settings.


Author(s):  
Jasashree Choudhury ◽  
Anuspandana Mahapatra

BackgroundThe objective of this study was to assess the knowledge of hand hygiene   of healthcare workers  in the neonatal and paediatric intensive care unit in a tertiary care hospital.Methods : Study was conducted  to assess  the knowledge of hand hygiene for the five moments of hand hygiene of WHO. Healthcare workers   were given a questionnaire during routine patient care on random basis and the data was collected. Data analysis was   performed using SPSS software version 13.Results : A total of 50 health care workers  were questioned during the observation period. Answers differed by role: nurses (25) and doctors (10).15 nurses have no knowledge of moments of hand hygiene and were excluded from study. Nurses  were more likely to use soap and water compared to waterless-alcohol-based hand hygiene practices. Doctors were most likely to use alcoholic hand rub.Conclusion : Though knowledge of  hand hygiene practice  is high ,use of alcohol-based disinfectant was found to be very low compared to soap and water. Keywords: Hand hygiene, Health care, Soap and water, Alcohol hand rub.


Author(s):  
Ann Leonard ◽  
Anna Rose Prior ◽  
Phyllis Reilly ◽  
Caroline Murray ◽  
Meghan O’ Brien ◽  
...  

Abstract Introduction Healthcare workers are at very high risk for SARS-CoV-2 exposure and infection. This study evaluated anti-SARS-CoV-2 seroprevalence in healthcare workers in a tertiary care hospital and then correlated seroprevalence with confirmed or suspected SARS-CoV-2 infection in this population since the onset of the COVID-19 pandemic. Method The study was approved by our institution’s Joint Research Ethics Committee in June 2020. All volunteers were provided with a consent form, an information leaflet and a questionnaire on the day before phlebotomy. Serum samples were collected from 1176 participants over a 3-month period and analysed using the Elecsys Anti-SARS-CoV-2 assay (Roche Diagnostics GmbH, Mannheim, Germany) which detects total antibodies against the nucleocapsid protein of SARs-COV-2. Results Overall anti-SARS-CoV-2 seroprevalence among participating healthcare workers was 17.9%. The rate of confirmed infection by real-time polymerase chain reaction molecular testing prior to participation was 12.2%. Of 211 participants who had a reactive antibody test result, 37% did not have COVID-19 infection confirmed at any point prior to participation in this study, either having had a swab which did not detect SARS-CoV-2 RNA or having never been tested. Seropositivity was the highest (30%) in the youngest quintile of age (20–29 years old). Staff with more patient contact had a higher seroprevalence of 19.5% compared to 13.4% in staff with less patient contact. Conclusion This study demonstrates that a substantial proportion of SARS-CoV-2 infections in healthcare workers may be asymptomatic or subclinical and thus potentially represent a significant transmission risk to colleagues and patients.


2011 ◽  
Vol 152 (24) ◽  
pp. 946-950 ◽  
Author(s):  
Miklós Gresz

According to the Semmelweis Plan for Saving Health Care, ”the capacity of the national network of intensive care units in Hungary is one but not the only bottleneck of emergency care at present”. Author shows on the basis of data reported to the health insurance that not on a single calendar day more than 75% of beds in intensive care units were occupied. There were about 15 to 20 thousand sick days which could be considered unnecessary because patients occupying these beds were discharged to their homes directly from the intensive care unit. The data indicate that on the whole bed capacity is not low, only in some institutions insufficient. Thus, in order to improve emergency care in Hungary, the rearrangement of existing beds, rather than an increase of bed capacity is needed. Orv. Hetil., 2011, 152, 946–950.


2020 ◽  
Vol 41 (S1) ◽  
pp. s27-s28
Author(s):  
Gita Nadimpalli ◽  
Lisa Pineles ◽  
Karly Lebherz ◽  
J. Kristie Johnson ◽  
David Calfee ◽  
...  

Background: Estimates of contamination of healthcare personnel (HCP) gloves and gowns with methicillin-resistant Staphylococcus aureus (MRSA) following interactions with colonized or infected patients range from 17% to 20%. Most studies were conducted in the intensive care unit (ICU) setting where patients had a recent positive clinical culture. The aim of this study was to determine the rate of MRSA transmission to HCP gloves and gown in non-ICU acute-care hospital units and to identify associated risk factors. Methods: Patients on contact precautions with history of MRSA colonization or infection admitted to non-ICU settings were randomly selected from electronic health records. We observed patient care activities and cultured the gloves and gowns of 10 HCP interactions per patient prior to doffing. Cultures from patients’ anterior nares, chest, antecubital fossa and perianal area were collected to quantify bacterial bioburden. Bacterial counts were log transformed. Results: We observed 55 patients (Fig. 1), and 517 HCP–patient interactions. Of the HCP–patient interactions, 16 (3.1%) led to MRSA contamination of HCP gloves, 18 (3.5%) led to contamination of HCP gown, and 28 (5.4%) led to contamination of either gloves or gown. In addition, 5 (12.8%) patients had a positive clinical or surveillance culture for MRSA in the prior 7 days. Nurses, physicians and technicians were grouped in “direct patient care”, and rest of the HCPs were included in “no direct care group.” Of 404 interactions, 26 (6.4%) of providers in the “direct patient care” group showed transmission of MRSA to gloves or gown in comparison to 2 of 113 (1.8%) interactions involving providers in the “no direct patient care” group (P = .05) (Fig. 2). The median MRSA bioburden was 0 log 10CFU/mL in the nares (range, 0–3.6), perianal region (range, 0–3.5), the arm skin (range, 0-0.3), and the chest skin (range, 0–6.2). Detectable bioburden on patients was negatively correlated with the time since placed on contact precautions (rs= −0.06; P < .001). Of 97 observations with detectable bacterial bioburden at any site, 9 (9.3%) resulted in transmission of MRSA to HCP in comparison to 11 (3.6%) of 310 observations with no detectable bioburden at all sites (P = .03). Conclusions: Transmission of MRSA to gloves or gowns of HCP caring for patients on contact precautions for MRSA in non-ICU settings was lower than in the ICU setting. More evidence is needed to help guide the optimal use of contact precautions for the right patient, in the right setting, for the right type of encounter.Funding: NoneDisclosures: None


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