COVID-19 Exposure Risk of Healthcare Personnel in Digestive Endoscopy: A Prospective Study

Abstract Background: Of many descriptive papers about healthcare workers’ (HW) COVID-19 infection, asymptomatic cases have not yet considered. Aims: The present study calculated the numbers of COVID-19 patients afferent to GI endoscopy and the number of positive HW using nasopharyngeal swabs (NS), serological rapid IgM/IgG tests (SRT) and serological quantitative IgG test (SQT).Methods: The study was conducted from 2ndto 30thApril 2020. All the recommended national and international indications on infection control measures were followed. Out of 1227 patients accepted, 1009 were included in the study. 38 HW were tested by NS, SRT and SQT. Descriptive statistical analyses were used to summarize the data.Results: 17 patients were diagnosed COVID-19 positive at NS. 9 patients were known positive at the time of the endoscopy and 8 were diagnosed COVID-19 positive after the procedure. Of the 38 HW, 2 were positive both to NS and SRT with IgM/IgG lines; 7 showed IgG line only at SRT, confirmed by SQT with negative NS. Other 7 HW showed not well-defined line of IgG at SRT, confirmed negative by SQT. The two cases positive to NS and IgM/IgG SRT were asymptomatic. The crude contagion’s rate (R0)was 0.41 and 1.7% of COVID-19 patients caused 19% of positive cases in HW.Conclusions: Not previously diagnosed COVID-19 patients expose HW to additional and incalculable risk of contamination. Association between different tests reduced the variability related to possible confounding factors and increases the accuracy. Since most cases in HW seem to go asymptomatic, large-scale tests using both NS and SRT for both HW and patients should be recommended to minimize the risk of in-hospital infection’s relapses.

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Knowledge, attitudes and practices regarding tuberculosis amongst healthcare workers in Moyen-Ogooué Province, Gabon

BMC Infectious Diseases ◽

10.1186/s12879-021-06225-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Anja Vigenschow ◽

Jean Ronald Edoa ◽

Bayode Romeo Adegbite ◽

Pacome Achimi Agbo ◽

Ayola A. Adegnika ◽

...

Keyword(s):

Infection Control ◽

Healthcare Workers ◽

Control Measures ◽

Tuberculosis Infection ◽

Healthcare Personnel ◽

Factors Associated ◽

Infection Control Measures ◽

High Knowledge ◽

Tuberculosis Infection Control ◽

Knowledge Levels

Abstract Background In countries with a high tuberculosis incidence such as Gabon, healthcare workers are at enhanced risk to become infected with tuberculosis due to their occupational exposure. In addition, transmission can occur between patients and visitors, if a tuberculosis infection is not suspected in time. Knowledge about tuberculosis and correct infection control measures are therefore highly relevant in healthcare settings. Methods We conducted an interviewer-administered knowledge, attitude and practice survey amongst healthcare workers in 20 healthcare facilities at all levels in the Moyen-Ogooué province, Gabon. Correctly answered knowledge questions were scored and then categorised into four knowledge levels. Additionally, factors associated with high knowledge levels were identified. Fisher’s Exact test was used to identify factors associated with high knowledge levels. Results A total of 103 questionnaires were completed by various healthcare personnel. The most-frequently scored category was ‘intermediate knowledge’, which was scored by 40.8% (42/103), followed by ‘good knowledge’ with 28.2% (29/103) and ‘poor knowledge’ with 21.4% (22/103) of participating healthcare workers, respectively. ‘Excellent knowledge’ was achieved by 9.7% (10/103) of the interviewees. Apart from the profession, education level, type of employing healthcare facility, as well as former training on tuberculosis were significantly associated with high knowledge scores. Attitudes were generally positive towards tuberculosis infection control efforts. Of note, healthcare workers reported that infection control measures were not consistently practiced; 72.8% (75/103) of the participants were scared of becoming infected with tuberculosis, and 98.1% saw a need for improvement of local tuberculosis control. Conclusions The survey results lead to the assumption that healthcare workers in the Moyen-Ogooué province are at high risk to become infected with tuberculosis. There is an urgent need for improvement of tuberculosis infection control training for local healthcare personnel, particularly for less trained staff such as assistant nurses. Furthermore, the lack of adequate infection control measures reported by staff could possibly be correlated with a lack of adequate facility structures and protective equipment and requires further investigation.

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Universal Masking to Control Healthcare-Associated Transmission of SARS-CoV-2

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2021.127 ◽

2021 ◽

pp. 1-24

Author(s):

Eliza R. Thompson ◽

Faith S. Williams ◽

Pat A. Giacin ◽

Shay Drummond ◽

Eric Brown ◽

...

Keyword(s):

Large Scale ◽

Infection Prevention ◽

Index Patient ◽

Field Investigation ◽

Point Prevalence ◽

Control Measures ◽

Prevention Measures ◽

Infection Control Measures ◽

Va Health Care System ◽

Healthcare Associated

Abstract Objective: To assess extent of a healthcare-associated outbreak of SARS-CoV-2 and evaluate effectiveness of infection control measures, including universal masking Design: Outbreak investigation including 4 large-scale point-prevalence surveys Setting: Integrated VA Health Care System with 2 facilities and 330 beds Participants: Index patient and 250 exposed patients and staff Methods: We identified exposed patients and staff and classified them as probable and confirmed cases based on symptoms and testing. We performed a field investigation and assessment of patient and staff interactions to develop probable transmission routes. Infection prevention interventions implemented included droplet and contact precautions, employee quarantine, and universal masking with medical and cloth facemasks. Four point-prevalence surveys of patient and staff subsets were conducted using real-time reverse-transcriptase polymerase chain reaction for SARS-CoV-2. Results: Among 250 potentially exposed patients and staff, 14 confirmed cases of Covid-19 were identified. Patient roommates and staff with prolonged patient contact were most likely to be infected. The last potential date of transmission from staff to patient was day 22, the day universal masking was implemented. Subsequent point-prevalence surveys in 126 patients and 234 staff identified 0 patient cases and 5 staff cases of Covid-19, without evidence of healthcare-associated transmission. Conclusions: Universal masking with medical facemasks was effective in preventing further spread of SARS-CoV-2 in our facility in conjunction with other traditional infection prevention measures.

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

Journal of Complementary and Integrative Medicine ◽

10.1515/jcim-2020-0422 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Fulwah Alqahtani ◽

Marzouqah Alanazi ◽

Wajdan Alassaf ◽

Fadilah Sfouq Aleanizy ◽

Muna Aljahany ◽

...

Keyword(s):

Emergency Department ◽

Longitudinal Study ◽

Healthcare Workers ◽

Respiratory Symptoms ◽

Control Measures ◽

University Hospital ◽

Respiratory Pathway ◽

Infection Control Measures ◽

Separate Pathway ◽

Respiratory Conditions

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.

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Healthcare personnel experiences implementing carbapenem-resistant Enterobacterales infection control measures at a ventilator-capable skilled nursing facility—A qualitative analysis

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2021.265 ◽

2021 ◽

pp. 1-7

Author(s):

Katharina R. Rynkiewich ◽

Jinal Makhija ◽

Mary Carl M. Froilan ◽

Ellen C. Benson ◽

Alice Han ◽

...

Keyword(s):

Infection Control ◽

Multidrug Resistant ◽

Control Measures ◽

Healthcare Personnel ◽

Skilled Nursing ◽

Infection Control Measures ◽

Carbapenem Resistant ◽

Resident Care ◽

Semistructured Interviews ◽

Self Protection

Abstract Objective: Ventilator-capable skilled nursing facilities (vSNFs) are critical to the epidemiology and control of antibiotic-resistant organisms. During an infection prevention intervention to control carbapenem-resistant Enterobacterales (CRE), we conducted a qualitative study to characterize vSNF healthcare personnel beliefs and experiences regarding infection control measures. Design: A qualitative study involving semistructured interviews. Setting: One vSNF in the Chicago, Illinois, metropolitan region. Participants: The study included 17 healthcare personnel representing management, nursing, and nursing assistants. Methods: We used face-to-face, semistructured interviews to measure healthcare personnel experiences with infection control measures at the midpoint of a 2-year quality improvement project. Results: Healthcare personnel characterized their facility as a home-like environment, yet they recognized that it is a setting where germs were ‘invisible’ and potentially ‘threatening.’ Healthcare personnel described elaborate self-protection measures to avoid acquisition or transfer of germs to their own household. Healthcare personnel were motivated to implement infection control measures to protect residents, but many identified structural barriers such as understaffing and time constraints, and some reported persistent preference for soap and water. Conclusions: Healthcare personnel in vSNFs, from management to frontline staff, understood germ theory and the significance of multidrug-resistant organism transmission. However, their ability to implement infection control measures was hampered by resource limitations and mixed beliefs regarding the effectiveness of infection control measures. Self-protection from acquiring multidrug-resistant organisms was a strong motivator for healthcare personnel both outside and inside the workplace, and it could explain variation in adherence to infection control measures such as a higher hand hygiene adherence after resident care than before resident care.

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Dynamics of the seroprevalence of SARS-CoV-2 antibodies among healthcare workers at a COVID-19 referral hospital in Milan, Italy

Occupational and Environmental Medicine ◽

10.1136/oemed-2020-107060 ◽

2021 ◽

pp. oemed-2020-107060

Author(s):

Laura Milazzo ◽

Alessia Lai ◽

Laura Pezzati ◽

Letizia Oreni ◽

Annalisa Bergna ◽

...

Keyword(s):

Healthcare Workers ◽

Referral Hospital ◽

Control Measures ◽

Referral Centre ◽

Single Centre ◽

Factors Associated ◽

Infection Control Measures ◽

Professional Exposure ◽

First Time ◽

Time Point

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.

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Factors Influencing Sputum Conversion among Smear-Positive Pulmonary Tuberculosis Patients in Morocco

ISRN Pulmonology ◽

10.1155/2013/486507 ◽

2013 ◽

Vol 2013 ◽

pp. 1-5 ◽

Cited By ~ 6

Author(s):

Khalid Bouti ◽

Mohammed Aharmim ◽

Karima Marc ◽

Mouna Soualhi ◽

Rachida Zahraoui ◽

...

Keyword(s):

Pulmonary Tuberculosis ◽

Stepwise Regression ◽

Control Measures ◽

Sputum Smear ◽

Tuberculosis Patients ◽

Infection Control Measures ◽

Factors Influencing ◽

Smear Positive Pulmonary Tuberculosis ◽

Sputum Conversion ◽

A Prospective Study

Background. Sputum smear-positive pulmonary tuberculosis patients expel infectious viable bacilli for a period following the commencement of treatment. Objective. To determine the time to sputum smear conversion and study the factors influencing it. Design. A prospective study was undertaken at our hospital in Rabat over a six-month period on a cohort of 119 sputum smear positive patients. Patients were followed up fortnightly. At each followup, specimens were collected and processed for microscopy using standard protocol. Results. 96.6% of our patients completed the study (4 deaths). Sputum conversion rate was 42% after two weeks, 73% after one month, and 95% after two months. Univariate and stepwise regression analysis showed that patients who had high smear grading, miliary, and bilateral radiologic lesions were more likely to undergo delayed sputum conversion (P<0.05). Other factors were thought to influence sputum conversion but were not statistically proven in our study. Conclusion. Since viable bacilli continue to be expelled for up to two months, infection control measures should be maintained for such a time. Patients with high smear grading, miliary, and bilateral radiologic lesions need to be monitored more closely.

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Healthcare Workers Infection Rate in the Era of Coronavirus Disease 2019 - in Tertiary Teaching Hospital

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2021.6584 ◽

2021 ◽

Vol 9 (A) ◽

pp. 651-658

Author(s):

Mona Mohiedden ◽

Aml M. Said ◽

Ahmed M. Ali ◽

Mohammed M. Abdel Razik ◽

Maha Ali Gad

Keyword(s):

Healthcare Workers ◽

Statistical Significance ◽

Descriptive Analysis ◽

Control Measures ◽

University Hospitals ◽

Cross Sectional ◽

Infection Control Measures ◽

Increased Risk ◽

Tertiary Teaching ◽

Potential Risk Factors

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.

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Tuberculosis in Healthcare Workers and Infection Control Measures at Primary Healthcare Facilities in South Africa

PLoS ONE ◽

10.1371/journal.pone.0076272 ◽

2013 ◽

Vol 8 (10) ◽

pp. e76272 ◽

Cited By ~ 36

Author(s):

Mareli M. Claassens ◽

Cari van Schalkwyk ◽

Elizabeth du Toit ◽

Eline Roest ◽

Carl J. Lombard ◽

...

Keyword(s):

South Africa ◽

Infection Control ◽

Primary Healthcare ◽

Healthcare Workers ◽

Control Measures ◽

Healthcare Facilities ◽

Infection Control Measures

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COVID-19 Critical Care Simulations: An International Cross-sectional Survey

10.21203/rs.3.rs-121001/v1 ◽

2020 ◽

Author(s):

Mohamad-Hani Temsah ◽

Abdulkarim Alrabiaah ◽

Ayman Al-Eyadhy ◽

Fahad Al-Sohime ◽

Abdullah Al Huzaimi ◽

...

Keyword(s):

Infection Control ◽

Healthcare Workers ◽

Primary Outcome ◽

Control Measures ◽

Team Leaders ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Patient Transport ◽

Infection Control Measures ◽

Better Than

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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Management of a Hospital-Wide COVID-19 Outbreak Affecting Patients and Healthcare Workers

SN Comprehensive Clinical Medicine ◽

10.1007/s42399-020-00597-2 ◽

2020 ◽

Vol 2 (12) ◽

pp. 2540-2545

Author(s):

Steffen Höring ◽

René Fussen ◽

Johannes Neusser ◽

Michael Kleines ◽

Thea Laurentius ◽

...

Keyword(s):

Infection Control ◽

Healthcare Workers ◽

Spatial Separation ◽

Control Measures ◽

Medical Conditions ◽

Hospital Workers ◽

Infection Control Team ◽

Healthcare Facilities ◽

Infection Control Measures ◽

Control Team

AbstractTo the best of our knowledge, here, we describe the first hospital-wide outbreak of SARS-CoV-2 that occurred in Germany in April 2020. We aim to share our experience in order to facilitate the management of nosocomial COVID-19 outbreaks in healthcare facilities. All patients and hospital workers were screened for SARS-CoV-2 repeatedly. An infection control team on the side was installed. Strict spatial separation of patients and intensified hygiene training of healthcare workers (HCW) were initiated. By the time of reporting, 26 patients and 21 hospital workers were infected with a cluster of cases in the geriatric department. Fourteen patients developed COVID-19 consistent symptoms and five patients with severe pre-existing medical conditions died. The outbreak was successfully contained after intensified infection control measures were implemented and no further cases among patients were detected over a period of 14 days. Strict application of standard infection control measures proved to be successful in the management of nosocomial SARS-CoV-2 outbreaks.

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