scholarly journals Preventing SARS-CoV-2 transmission in the emergency department by implementing a separate pathway for patients with respiratory conditions

Author(s):  
Fulwah Alqahtani ◽  
Marzouqah Alanazi ◽  
Wajdan Alassaf ◽  
Fadilah Sfouq Aleanizy ◽  
Muna Aljahany ◽  
...  

Abstract Objectives This study aimed to describe the development and implementation of a separated pathway to check and treat patients with a suspected/confirmed coronavirus disease 2019 (COVID-19) in the emergency department (ED) at King Abdullah bin Abdulaziz University Hospital in Riyadh. Methods We conducted a retrospective, descriptive longitudinal study from March to July 2020 by analyzing data of all confirmed cases of COVID-19 among ED visitors and healthcare workers in King Abdullah bin Abdulaziz University Hospital. Results During the study period, a total of 1,182 swab samples were collected for testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), of which 285 (24.1%) tested positive. Of the 285 cases of confirmed SARS-CoV-2 infection, 18 were healthcare workers and 267 were patients. As a result of using the respiratory pathway for COVID-19 patients, the hospital managed to limit transmission of SARS-CoV-2 not only between patients but also between patients and healthcare workers, while also containing the pandemic. There were no cases of nosocomial SARS-CoV-2 infection recorded among the patients who visited the ED or the flu clinic. All confirmed cases were community acquired and patients were cared for under constrained measures. Conclusions Implementing infection control measures and restricting those with respiratory symptoms to the ED pathway prevented nosocomial spread of SARS-CoV-2 infection in the ED.

2016 ◽  
Vol 37 (10) ◽  
pp. 1147-1155 ◽  
Author(s):  
Hanan H. Balkhy ◽  
Thamer H. Alenazi ◽  
Majid M. Alshamrani ◽  
Henry Baffoe-Bonnie ◽  
Yaseen Arabi ◽  
...  

BACKGROUNDSince the first isolation of Middle East respiratory syndrome coronavirus (MERS-CoV) in Saudi Arabia in 2012, sporadic cases, clusters, and sometimes large outbreaks have been reported.OBJECTIVETo describe the recent (2015) MERS-CoV outbreak at a large tertiary care hospital in Riyadh, Saudi Arabia.METHODSWe conducted an epidemiologic outbreak investigation, including case finding and contact tracing and screening. MERS-CoV cases were categorized as suspected, probable, and confirmed. A confirmed case was defined as positive reverse transcription polymerase chain reaction test for MERS-CoV.RESULTSOf the 130 suspected cases, 81 (62%) were confirmed and 49 (38%) were probable. These included 87 patients (67%) and 43 healthcare workers (33%). Older age (mean [SD], 64.4 [18.3] vs 40.1 [11.3] years, P<.001), symptoms (97% vs 58%, P<.001), and comorbidity (99% vs 42%, P<.001) were more common in patients than healthcare workers. Almost all patients (97%) were hospitalized whereas most healthcare workers (72%) were home isolated. Among 96 hospitalized cases, 63 (66%) required intensive care unit management and 60 (63%) required mechanical ventilation. Among all 130 cases, 51 (39%) died; all were patients (51 [59%]) with no deaths among healthcare workers. More than half (54%) of infections were believed to be caught at the emergency department. Strict infection control measures, including isolation and closure of the emergency department, were implemented to interrupt the chain of transmission and end the outbreak.CONCLUSIONMERS-CoV remains a major healthcare threat. Early recognition of cases and rapid implementation of infection control measures are necessary.Infect Control Hosp Epidemiol 2016;1–9


2020 ◽  
Vol 36 (3) ◽  
Author(s):  
Muhammad Mohsin Ali ◽  
Qudsia Anwar Dar ◽  
Zahid Kamal ◽  
Alishba Khan

This is a brief review covering the currently available literature on ocular manifestations of COVID-19, andprevention strategies for ophthalmologists. A literature search was carried out of Pubmed, Google Scholar andWHO database of publications on COVID. Keywords used in the search were eye, ocular manifestations,ophthalmology, COVID-19, nCoV-2019, and coronavirus disease. All available articles were reviewed and thosepertinent to the study topic were included. Considering the dearth of information available, ophthalmology journals were also searched separately for relevant articles. Major ocular manifestation of COVID reported in literature is red eye, which usually presents before the onset of respiratory symptoms. Since the eye can be a possible transmission route for SARS-CoV-2, infection control measures should be undertaken by ophthalmologists, including use of personal protection equipment and eye/face covering. A framework for structuring ophthalmological services during the COVID pandemic is also presented in this review.


2021 ◽  
pp. oemed-2020-107060
Author(s):  
Laura Milazzo ◽  
Alessia Lai ◽  
Laura Pezzati ◽  
Letizia Oreni ◽  
Annalisa Bergna ◽  
...  

ObjectivesHealthcare workers (HCWs) are at high risk of developing SARS-CoV-2 infection. The aim of this single-centre prospective study was to evaluate the trend of SARS-CoV-2 seroprevalence in HCWs working at the primary referral centre for infectious diseases and bioemergencies (eg, COVID-19) in Northern Italy and investigate the factors associated with seroconversion.MethodsSix hundred and seventy-nine HCW volunteers were tested for anti-SARS-CoV-2 antibodies three times between 4 March and 27 May 2020 and completed a questionnaire covering COVID-19 exposure, symptoms and personal protective equipment (PPE) training and confidence at each time.ResultsSARS-CoV-2 seroprevalence rose from 3/679 to 26/608 (adjusted prevalence: 0.5%, 95% CI 0.1 to 1.7% and 5.4%, 95% CI 3.6 to 7.9, respectively) between the first two time points and then stabilised, in line with the curve of the COVID-19 epidemic in Milan. From the first time point, 61.6% of the HCWs had received training in the use of PPE and 17 (61.5%) of those who proved to be seropositive reported symptoms compatible with SARS-CoV-2 infection. Contacts with ill relatives or friends and self-reported symptoms were independently associated with an increased likelihood of seroconversion (p<0.0001 for both), whereas there was no significant association with professional exposure.ConclusionThe seroprevalence of SARS-CoV-2 among the HCWs at our COVID-19 referral hospital was low at the time of the peak of the epidemic. The seroconversions were mainly attributable to extrahospital contacts, probably because the hospital readily adopted effective infection control measures. The relatively high number of asymptomatic seropositive HCWs highlights the need to promptly identify and isolate potentially infectious HCWs.


2009 ◽  
Vol 58 (2) ◽  
pp. 209-216 ◽  
Author(s):  
T. W. Boo ◽  
F. Walsh ◽  
B. Crowley

A 30 month prospective study of Acinetobacter species encountered in the Central Pathology Laboratory of St James's Hospital, Dublin, Ireland, was conducted to investigate the prevalence and molecular epidemiology of carbapenem resistance in such isolates. Acinetobacter genomic species 3 (AG3) was found to be the predominant Acinetobacter species (45/114, 39 %) in our institution. A total of 11 % of all Acinetobacter species (12/114) and 22 % of AG3 isolates (10/45) were carbapenem resistant. Carbapenem resistance was mediated by Ambler class D β-lactamase OXA-23 in all 12 isolates, with insertion sequence ISAba1 found upstream of bla OXA-23. ISAba1 was also found upstream of bla ADC-25, which encodes the enzyme AmpC, in an Acinetobacter baumannii isolate, and upstream of the aminoglycoside-acetyltransferase-encoding gene aacC2 in three AG3 isolates. Inter-species plasmidic transfer was most likely involved in the emergence and spread of bla OXA-23 among the Acinetobacter isolates within our institution. The emergence of carbapenem resistance was associated not only with prior carbapenem use but also with the use of other antimicrobial agents, most notably β-lactam/β-lactamase-inhibitor combinations. The study demonstrated the emerging trend of carbapenem resistance in the wider context of the Acinetobacter genus, and reiterated the paramount importance of the prudent use of antimicrobial agents, stringent infection control measures and resistance surveillance of pathogens.


2021 ◽  
Vol 9 (A) ◽  
pp. 651-658
Author(s):  
Mona Mohiedden ◽  
Aml M. Said ◽  
Ahmed M. Ali ◽  
Mohammed M. Abdel Razik ◽  
Maha Ali Gad

BACKGROUND: Healthcare workers (HCWs) are at the frontline defense against coronavirus disease 2019 (COVID-19) pandemic. AIM: The study aimed to describe the characteristics and appraise potential risk factors of COVID-19 transmission among HCWs who tested positive for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in one of Cairo University Hospitals. METHOD: Cross-sectional descriptive analysis of confirmed polymerase chain reaction (PCR) positive versus negative cases for COVID-19. RESULTS: Through March–June 2020, (145/846; 17%) suspected HCWs were tested for COVID-19 by PCR; out of them (70/145; 48.3%) were confirmed as positive, these positive cases represented (70/846; 8.3%) of all HCWs of the hospital. About 33% of confirmed COVID-19 positive HCWs acquired the infection from the healthcare while only (13/70; 19%) from community settings, and no clear exposure data were identified in (34/70; 48%) of cases. Most of symptomatic cases showed a positive PCR test for SARS-CoV-2 versus asymptomatic cases, p < 0.001. There was no statistical significance regarding gender, age, presence of comorbidity, workload or the type of acquisition. CONCLUSION: HCWs are at an increased risk of COVID-19 infection at the workplace. Strict implementation of infection control measures is of crucial role in preventing transmission of COVID-19 infection in health-care settings.


CJEM ◽  
2020 ◽  
Vol 22 (S1) ◽  
pp. S60-S61
Author(s):  
K. Zhou ◽  
D. Junqueira ◽  
S. Couperthwaite ◽  
J. Meyer ◽  
B. Rowe

Introduction: Inhaled toxins from tobacco smoking, cannabis leaf smoking as well as vaping/e-cigarette products use are known causes of cardio-respiratory injury. While tobacco smoking has decreased among Canadian adults, there are now several other forms of legal inhalant products. While legal, the evidence of benefit and safety of vaping is limited. Of concern, cases of e-cigarette or vaping products use associated lung injury (EVALI) have been accumulating in the U.S. and now in Canada. Despite this, very little is known about the inhalation exposure of emergency department (ED) patients; this study was designed to explore lung health in the ED. Methods: We investigated the prevalence of exposure to vaping, tobacco and cannabis among patients presenting to a Canadian ED from July to November 2019. Ambulatory (CTAS 2 to 5), stable, adult (≥ 17 years) patients were prospectively identified and invited to complete a survey addressing factors related to lung health (previous diagnosis of respiratory conditions and respiratory symptoms at the ED presentation) and information on current exposure to vaping, tobacco and cannabis smoking. Categorical variables are reported as frequencies and percentages; continuous variables are reported as medians with interquartile range (IQR). The study was approved by the Health Research Ethics Board. Results: Overall, 1024 (71%) of 1433 eligible patients completed the survey. The median age was 43.5 (IQR: 29, 60), and 51% were female. A total of 351 (31%) participants reported having been previously diagnosed with ≥1 respiratory conditions, and 177 (17%) were visiting the ED as a result of ≥1 respiratory symptoms (e.g., cough, shortness of breath, wheezing). Daily tobacco smoking was reported by 190 (19%), and 83 (8%) reported using vaping/e-cigarette products. Cannabis use within 30 days was described by 80 (15%) respondents. Exposure to tobacco and vaping products was reported by 39 (4%) participants, 63 (6%) reported using tobacco in combination with cannabis smoking, and 3% reported combining vaping and cannabis use. Conclusion: Patients seeking care in the ED are exposed to a large quantity of inhaled toxins. Vaping products, considered the cause of the most recent epidemic of severe lung injury, are used in isolation and in combination with other smoking products in Canada. These exposures should be documented and may increase the risk of lung health injuries and exacerbations of chronic respiratory conditions.


Author(s):  
Hyppolite K Tchidjou ◽  
Bernard Romeo

Abstract Since 2019 coronavirus disease (COVID-19) is highly contagious with a high mortality rate. France has taken strict infection control measures. According to the report by the Center for Disease Control and Prevention, children are less affected with COVID-19 and seem to have less severe disease than adults. We reported the first confirmed infant case of co-infection with SARS-CoV-2 and Citrobacter koseri urinary infection in 6-week-old child admitted on 25 March 2020 with mild symptoms in the Pediatric COVID Unit of Amiens University Hospital, France.


PLoS ONE ◽  
2013 ◽  
Vol 8 (10) ◽  
pp. e76272 ◽  
Author(s):  
Mareli M. Claassens ◽  
Cari van Schalkwyk ◽  
Elizabeth du Toit ◽  
Eline Roest ◽  
Carl J. Lombard ◽  
...  

2020 ◽  
Author(s):  
Mohamad-Hani Temsah ◽  
Abdulkarim Alrabiaah ◽  
Ayman Al-Eyadhy ◽  
Fahad Al-Sohime ◽  
Abdullah Al Huzaimi ◽  
...  

Abstract Background: Many healthcare systems initiated rapid training with COVID-19 simulations for their healthcare workers (HCWs) to build surge capacity and optimize infection control measures. This study aimed to describe COVID-19 simulation drills in international healthcare centers. Methods: This is a cross-sectional survey among simulation team leaders and HCWs, based on each center's debriefing reports from simulation centers from 30 countries in all WHO regions where COVID-19 simulation drills were conducted. The primary outcome measures were the COVID-19 simulations' characteristics, outcomes, facilitators, obstacles, and challenges encountered during the simulation sessions. Results: Invitation was sent to 500 simulation team leaders and HCWs, and 343 responded. Those who completed the study comprised 121 participants: 62.8% females; 56.2% physicians; 41.3% from East Mediterranean (EMRO) countries; 25.6% from Southeast Asian countries (SERO); and 12.4% from Europe. The frequency of simulation sessions was monthly (27.1%), weekly (24.8%), twice weekly (19.8%), or daily (21.5%). Among participants, 55.6% reported the team's full engagement in the simulation sessions. The average session length was 30–60 minutes. The most commonly reported debriefing leaders were ICU staff, simulation lab staff, and E.R. facilitators, and the least common were infection control staff. A total of 80% reported "a lot" to "a great improvement" in terms of clinical preparedness after simulation sessions, and 70% were satisfied with the COVID-19 simulation sessions and thought they were better than expected. Most of the perceived issues reported were related to infection control measures, followed by team dynamics, logistics, and patient transport issues. Conclusion: Simulation centers team leaders and HCWs reported positive feedback on COVID-19 simulation sessions. The presence of multiprofessional personnel during drills is warranted. These drills are a valuable tool for rehearsing safe dynamics of HCWs on the frontline of COVID-19.Trial registration: Not applicable.


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