Surveillance on Healthcare Workers During the First Wave of SARS-CoV-2 Pandemic in Italy: The Experience of a Tertiary Care Pediatric Hospital

Healthcare workers (HCWs) play a central role in handling the ongoing coronavirus disease 2019 (COVID-19) pandemic. Monitoring HCWs, both symptomatic and asymptomatic, through screening programs, are critical to avoid the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in the hospital environment to rapidly identify and isolate infected individuals and to allow their prompt return to work as soon as necessary. We aim to describe our healthcare surveillance experience (April 2–May 6, 2020) based on a combined screening consisting of real-time PCR (RT-PCR) on nasopharyngeal (NP) swabs and rapid serologic tests (RST) for SARS-CoV-2 in all HCWs of Meyer Children's University Hospital in Florence. Among the analyzed workers, 13/1690 (0.8%), all of them without clinical manifestations, was found positive for SARS-CoV-2 by using RT-PCR on NP swab: 8/1472 (0.5%) were found positive during the screening, 1/188 (0.5%) during contact with a positive individual (p > 0.05 vs. screening group), while 4/30 (13.3%) were found positive on the day of re-admission at work after an influenza-like-illness (p < 0.05). Concerning working areas, the majority of RT-PCR positivity (12/13) and serologic positivity (34/42) was found in non-COVID-19 dedicated areas (p > 0.05 vs. COVID-19 dedicated areas). No cases were registered among non-patients-facing workers (p = 0.04 vs. patient-facing group). Nurses and residents represented, respectively, the working role with the highest and lowest percentage of RT-PCR positivity. In conclusion, accurate surveillance is essential to reduce virus spread among HCWs, patients, and the community and to limit the shortage of skilled professionals. The implementation of the surveillance system through an efficient screening program was offered to all professionals, regardless of the presence of clinical manifestations and the level of working exposure risk, maybe wise and relevant.

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SARS-CoV-2 Antibody Screening in Healthcare Workers in Non-Infectious Hospitals in Two Different Regions of Southern Poland (Upper Silesia and Opole Voivodeships): A Prospective Cohort Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18084376 ◽

2021 ◽

Vol 18 (8) ◽

pp. 4376

Author(s):

Rafał Jakub Bułdak ◽

Elżbieta Woźniak-Grygiel ◽

Marta Wąsik ◽

Janusz Kasperczyk ◽

Ewa Gawrylak-Dryja ◽

...

Keyword(s):

Healthcare Workers ◽

Elisa Test ◽

University Hospital ◽

Hospital Environment ◽

Blood Collection ◽

Test Results ◽

Rt Pcr ◽

Local Surgery ◽

The University ◽

Pcr Test

(1) Background: Detection of asymptomatic or subclinical human coronavirus SARS-CoV-2 infection in healthcare workers (HCWs) is crucial for understanding the overall prevalence of the new coronavirus and its infection potential in public (non-infectious) healthcare units with emergency wards. (2) Methods: We evaluated the host serologic responses, measured with semi-quantitative ELISA tests (IgA, IgG, IgM abs) in sera of 90 individuals in Hospital no. 4 in Bytom, 84 HCWs in the University Hospital in Opole and 25 in a Miasteczko Śląskie local surgery. All volunteers had negative RT-PCR test results or had not had the RT-PCR test performed within 30 days before sampling. The ELISA test was made at two different time points (July/August 2020) with a 2-weeks gap between blood collections to avoid the “serological window” period. (3) Results: The IgG seropositivity of asymptomatic HCWs varied between 1.2% to 10% (Opole vs. Bytom, p < 0.05; all without any symptoms). IgA seropositivity in HCWs was 8.8% in Opole and 7.14% in Bytom. IgM positive levels in HCWs in Opole and Bytom was 1.11% vs. 2.38%, respectively. Individuals with IgA and IgM seropositivity results were observed only in Opole (1.19%). More studies are needed to determine whether these results are generalizable to other populations and geographic as well as socio-demographic locations. (4) Conclusions: 100% of IgG(+) volunteers were free from any symptoms of infection in the 30 days before first or second blood collection and they had no awareness of SARS-CoV-2 infection. Asymptomatic HCWs could spread SARS-CoV-2 infection to other employees and patients. Only regular HCWs RT-PCR testing can reduce the risk of SARS-CoV-2 spreading in a hospital environment. The benefit of combining the detection of specific IgA with that of combined specific IgM/IgG is still uncertain.

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Implementation of a Targeted Screening Program to Detect Airflow Obstruction Suggestive of Chronic Obstructive Pulmonary Disease within a Presurgical Screening Clinic

Canadian Respiratory Journal ◽

10.1155/2015/306720 ◽

2015 ◽

Vol 22 (4) ◽

pp. 209-214 ◽

Cited By ~ 5

Author(s):

Chantal Robitaille ◽

Esther Dajczman ◽

Andrew M Hirsch ◽

David Small ◽

Pierre Ernst ◽

...

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Disease ◽

Screening Program ◽

Tertiary Care ◽

Airflow Obstruction ◽

University Hospital ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Targeted Screening ◽

History Of

BACKGROUND: Targeted spirometry screening for chronic obstructive pulmonary disease (COPD) has been studied in primary care and community settings. Limitations regarding availability and quality of testing remain. A targeted spirometry screening program was implemented within a presurgical screening (PSS) clinic to detect undiagnosed airways disease and identify patients with COPD/asthma in need of treatment optimization.OBJECTIVE: The present quality assurance study evaluated airflow obstruction detection rates and examined characteristics of patients identified through the targeted screening program.METHODS: The targeted spirometry screening program was implemented within the PSS clinic of a tertiary care university hospital. Current or ex-smokers with respiratory symptoms and patients with a history of COPD or asthma underwent prebronchodilator spirometry. History of airways disease and smoking status were obtained during the PSS assessment and confirmed through chart reviews.RESULTS: After exclusions, the study sample included 449 current or ex-smokers. Abnormal spirometry results were found in 184 (41%) patients: 73 (16%) had mild, 93 (21%) had moderate and 18 (4%) had severe or very severe airflow obstruction. One hundred eighteen (26%) new cases of airflow obstruction suggestive of COPD were detected. One-half of these new cases had moderate or severe airflow obstruction. Only 34% of patients with abnormal spirometry results had reported a previous diagnosis of COPD. More than one-half of patients with abnormal spirometry results were current smokers.CONCLUSIONS: Undiagnosed airflow obstruction was detected in a significant number of smokers and ex-smokers through a targeted screening program within a PSS clinic. These patients can be referred for early intervention and secondary preventive strategies.

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

Open Forum Infectious Diseases ◽

10.1093/ofid/ofab466.621 ◽

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

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754. Prevalence of Latent Tuberculosis Infection Among Healthcare Workers at a Tertiary Care University Hospital

Open Forum Infectious Diseases ◽

10.1093/ofid/ofy210.761 ◽

2018 ◽

Vol 5 (suppl_1) ◽

pp. S271-S271

Author(s):

Eun Ju Choo ◽

Se Yoon Park

Keyword(s):

Risk Factors ◽

Healthcare Workers ◽

Latent Tuberculosis Infection ◽

Tertiary Care ◽

Latent Tuberculosis ◽

Tuberculosis Infection ◽

University Hospital ◽

Increased Risk ◽

High Prevalence ◽

Univariate Analyses

Abstract Background We investigated the prevalence of latent tuberculosis infection (LTBI) among healthcare workers (HCWs) and analyzed its risk factors in a tertiary care university hospital in South Korea in a population with intermediate tuberculosis (TB) burden. Methods A standard questionnaire regarding the baseline demographics and risk factors for LTBI was given to each participant. QuantiFERON-TB GOLD In-Tube (QFT-GIT) assay and chest radiography were performed to investigate the rate of LTBI. Results A total of 1,429 participants, 213 (14.9%) doctors and 988 (69.1%) nurses and 228 (16.0%) others were enrolled. The mean age of the subjects was 33.0 years old, and 1,175 (82.2%) were female. Of the participants, 94.5% had received BCG vaccine. QFT-GIT assays were positive for 156 subjects (10.9%). Of the 213 doctors, 28 (13.1%) were positive by QFT-GIT, and among the 988 nurses, 94 (9.5%) had positive QFT-GIT results. Experience of working in hospital was significantly associated with positive LTBI test results by QFT-GIT assay. Gender and duration of employment as an HCW were significantly associated with having a positive QFT-GIT result in univariate analyses. In multivariate analyses, duration of employment as an HCW (>15 years) (odds ratio, 1.98; 95% confidence interval, 1.14–3.43) was independently associated with increased risk of a positive QFT-GIT result. Conclusion A high prevalence of LTBI was found among our HCWs. Considering the association between the experience of working in hospital and high risk of LTBI. The risk for tuberculosis infection among HCWs was higher than general population, which suggests that stricter preventive strategies against nosocomial tuberculosis infection should be implemented. Disclosures All authors: No reported disclosures.

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First Trimester Aneuploidy Screening Program for Preeclampsia Prediction in a Portuguese Obstetric Population

Obstetrics and Gynecology International ◽

10.1155/2014/435037 ◽

2014 ◽

Vol 2014 ◽

pp. 1-7 ◽

Cited By ~ 2

Author(s):

Cláudia Teixeira ◽

Eduardo Tejera ◽

Helena Martins ◽

António Tomé Pereira ◽

Altamiro Costa-Pereira ◽

...

Keyword(s):

Logistic Regression ◽

Late Onset ◽

Screening Program ◽

First Trimester ◽

University Hospital ◽

Aneuploidy Screening ◽

Detection Rates ◽

Crown Rump Length ◽

Screening Programs ◽

Obstetric Population

Objective. To evaluate the performance of a first trimester aneuploidy screening program for preeclampsia (PE) prediction in a Portuguese obstetric population, when performed under routine clinical conditions.Materials and Methods. Retrospective cohort study of 5672 pregnant women who underwent routine first trimester aneuploidy screening in a Portuguese university hospital from January 2009 to June 2013. Logistic regression-based predictive models were developed for prediction of PE based on maternal characteristics, crown-rump length (CRL), nuchal translucency thickness (NT), and maternal serum levels of pregnancy-associated plasma protein-A (PAPP-A) and free beta-subunit of human chorionic gonadotropin (freeβ-hCG).Results. At a false-positive rate of 5/10%, the detection rate for early-onset (EO-PE) and late-onset (LO-PE) PE was 31.4/45.7% and 29.5/35.2%, respectively. Although both forms of PE were associated with decreased PAPP-A, logistic regression analysis revealed significant contributions from maternal factors, freeβ-hCG, CRL, and NT, but not PAPP-A, for prediction of PE.Conclusion. Our findings support that both clinical forms of EO-PE and LO-PE can be predicted using a combination of maternal history and biomarkers assessed at first trimester aneuploidy screening. However, detection rates were modest, suggesting that models need to be improved with additional markers not included in the current aneuploidy screening programs.

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Outbreak of Kawasaki disease in children during COVID-19 pandemic: a prospective observational study in Paris, France

10.1101/2020.05.10.20097394 ◽

2020 ◽

Cited By ~ 17

Author(s):

Julie Toubiana ◽

Clement Poirault ◽

Alice Corsia ◽

Fanny Bajolle ◽

Jacques Fourgeaud ◽

...

Keyword(s):

Kawasaki Disease ◽

Early Stage ◽

African Ancestry ◽

Clinical Manifestations ◽

Gastrointestinal Symptoms ◽

Sub Saharan Africa ◽

University Hospital ◽

Antibody Detection ◽

Rt Pcr ◽

Igg Antibody

Background: Acute clinical manifestations of SARS-CoV-2 infection are less frequent and less severe in children than in adults. However, recent observations raised concerns about potential post-viral severe inflammatory reactions in children infected with SARS-CoV-2. Methods: We describe an outbreak of cases of Kawasaki disease (KD) admitted between April 27 and May 7, 2020, in the general paediatrics department of a university hospital in Paris, France. All children prospectively underwent nasopharyngeal swabs for SARS-CoV-2 RT-PCR, SARS-CoV-2 IgG serology testing, and echocardiography. The number of admissions for KD during the study period was compared to that observed since January 1, 2018, based on discharge codes, using Poisson regression. Results: A total of 17 children were admitted for KD over an 11-day period, in contrast with a mean of 1.0 case per 2-week period over 2018-2019 (Poisson incidence rate ratio: 13.2 [95% confidence interval: 7.3-24.1], p <0.001). Their median age was 7.5 (range, 3.7-16.6) years, and 59% of patients originated from sub-Saharan Africa or Caribbean islands. Eleven patients presented with KD shock syndrome (KDSS) requiring intensive care support, and 12 had myocarditis. All children had marked gastrointestinal symptoms at the early stage of illness and high levels of inflammatory markers. Fourteen patients (82%) had evidence of recent SARS-CoV-2 infection (positive RT-PCR 7/17, positive IgG antibody detection 14/16). All patients received immunoglobulins and some received corticosteroids (5/17). The clinical outcome was favourable in all patients. Moderate coronary artery dilations were detected in 5 cases (29%) during hospitalisation. Conclusions: The ongoing outbreak of KD in the Paris might be related to SARS-CoV2, and shows an unusually high proportion of children with gastrointestinal involvement, KDSS and African ancestry.

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Clinico-epidemiological profile of COVID-19 among health care workers from a tertiary care hospital

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20212812 ◽

2021 ◽

Author(s):

Anuradha Tolpadi ◽

Abhijeet Mane ◽

Jitendra Oswal ◽

Sujata Rege ◽

Meera Modak ◽

...

Keyword(s):

Healthcare Workers ◽

Tertiary Care ◽

Management Strategies ◽

Care Hospital ◽

Antigen Test ◽

Rt Pcr ◽

Tertiary Care Centre ◽

Care Workers ◽

Global Health Issue ◽

Epidemiological Profile

Background: Coronavirus disease 2019 (COVID-19) is a global health issue. Healthcare workers (HCWs) are especially vulnerable to infection by SARS-CoV-2. The present study was conducted to determine the proportion of HCWs infected with COVID 19 in a tertiary care centre with emphasis on the epidemiological and clinical aspectMethods: HCWs (symptomatic and asymptomatic contacts) who tested positive for COVID-19 by SARS-CoV-RTPCR or COVID-19 rapid antigen test were included in the study. Demographic and clinical data of the infected HCWs was obtained through a detailed telephonic interview with structured questionnaire.Results: Out of total 921 HCWs tested for COVID-19 (SARS-CoV-2 RT-PCR and Rapid antigen test), 323 (35%) HCWs were positive. Proportion of COVID-19 positive HCWs among all HCWs was 13.67% (323/2362). Most COVID-19 positive HCWs (88%) were symptomatic. Majority of infected HCWs (62.23%) were between the age group of 21-30 years. Nurses were the most predominantly affected among various categories of HCWs (42.41%). Fever was the most common presenting symptom, seen in 160 (49.50%) HCWs. Comorbidities were found in 28 (8.66%) of infected HCWs. Majority of HCWs (86%) suffered from mild infection.Conclusions: HCWs, especially nurses, face a high risk of COVID-19 infection while providing care for suspected or confirmed COVID-19 patients. It is important to characterize the epidemiological and clinical profile of HCWs regarding COVID-19 for formulation of prevention and management strategies.

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Incidence of Pertussis Infection in Healthcare Workers

Infection Control and Hospital Epidemiology ◽

10.1086/501593 ◽

1999 ◽

Vol 20 (02) ◽

pp. 120-123 ◽

Cited By ~ 57

Author(s):

Seth W. Wright ◽

Michael D. Decker ◽

Kathryn M. Edwards

Keyword(s):

Emergency Department ◽

Pertussis Toxin ◽

Healthcare Workers ◽

Tertiary Care ◽

Annual Incidence ◽

University Hospital ◽

Serological Evidence ◽

Pertussis Infection ◽

Symptomatic Disease ◽

Filamentous Hemagglutinin

AbstractObjective:To determine the incidence of pertussis infection in two groups of healthcare workers.Design:Retrospective cohort study.Setting:660-bed, urban, tertiary-care university hospital.Participants:106 resident physicians and 39 emergency department employees.Interventions:Antibodies to pertussis toxin and filamentous hemagglutinin were determined in fresh serum specimens and in stored sera collected 1 to 3 years previously. A 50% rise in both the pertussis toxin and filamentous hemagglutinin from the initial to the follow-up specimen was considered diagnostic of a pertussis infection.Results:Two of 106 residents had serological evidence of a pertussis infection during 151.3 subject-observation years, for an annual incidence rate of 1.3% (95% confidence interval [CI95], 0%-3.5%). Three of 39 emergency department employees had serological evidence of a pertussis infection during 81.2 subject-observation years, for an annual incidence of 3.6% (CI95,, 0%-9.6%). Of these 5 subjects, 2 had symptomatic disease.Conclusion:We found both symptomatic and asymptomatic pertussis infections in two cohorts of healthcare workers. Although the incidence rates were somewhat lower than found in other studies, they nonetheless were higher than for almost all other diseases for which we vaccinate healthcare workers. Our results would support the use of acellular pertussis vaccine in healthcare workers.

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Physical health complaints among healthcare workers engaged in the care of critically ill COVID-19 patients: A single tertiary-care center prospective study from Japan

10.1101/2020.10.09.20210393 ◽

2020 ◽

Author(s):

Hiroki Namikawa ◽

Yoshihiro Tochino ◽

Akiko Okada ◽

Keiko Ota ◽

Yasuyo Okada ◽

...

Keyword(s):

At Risk ◽

Prospective Study ◽

Physical Health ◽

Critically Ill ◽

Healthcare Workers ◽

Tertiary Care ◽

Physical Symptoms ◽

University Hospital ◽

Health Complaints ◽

Increased Risk

AbstractBackgroundHealthcare workers (HCWs) who care for patients with the novel coronavirus infectious disease (COVID-19) are at an increased risk and fear contracting the infection themselves. HCWs are chronically exposed to very intense stress, both and physically and mentally. Hospitals must reduce both the physical and mental burden of HCWs on the front lines and ensure their safety. No prospective study has focused on the physical health complaints among HCWs engaged in the care of critically ill COVID-19 patients. This study aimed to investigate the occupational risk among HCWs of experiencing physical symptoms during the current COVID-19 pandemic.MethodsA twice-weekly questionnaire targeting HCWs who care for COVID-19 patients was performed at Osaka City University Hospital from April 30 to May 31, 2020 using a shareable Research Electronic Data Capture tool. The demographic characteristics of the participants, frequency of exposure to at-risk care, and physical complaints were evaluated.ResultsA total of 35 doctors, 88 nurses, and 35 technicians were engaged in the care of these critically ill COVID-19 patients. 76 HCWs participated in this study, of whom 24 (31.6%) were doctors, 43 (56.6%) were nurses, and 9 (11.8%) were technicians. The frequency of experiencing any physical symptom was 25.0% among HCWs. Exposure to at-risk care was significantly higher among nurses than among doctors (p < 0.001); likewise, the frequency of experiencing physical symptoms was higher among nurses than among doctors (p < 0.01). The multivariate analysis revealed that nurses (odds ratio 8.29; p = 0.01) might be independently at risk of experiencing physical symptoms.ConclusionsOur results indicate that occupational health care at hospitals must be allocated to HCWs who are highly exposed to at-risk care, particularly nurses engaged in the care of COVID-19 patients.

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Multidrug-resistant Gram-negative bacteria from patients, hospital environment and healthcare workers: a six-month cross-sectional study

10.1101/425330 ◽

2018 ◽

Cited By ~ 1

Author(s):

Aline F. R. Sereia ◽

Patricia A. da Cunha ◽

Daniela C. Tartari ◽

Caetana P. Zamparette ◽

Diana A. Estigarribia ◽

...

Keyword(s):

Healthcare Workers ◽

Screening Program ◽

Carbapenem Resistance ◽

Multidrug Resistant ◽

Hospital Environment ◽

Surveillance Program ◽

Gram Negative Bacteria ◽

Cross Sectional ◽

Gram Negative ◽

Hospital Units

AbstractHealthcare-associated infections (HAI) are an important public health threat with the multidrug-resistant (MDR) gram-negative bacteria (GNB) being of particular concern. Here we present the antimicrobial resistance profile of HAI-related GNB (HAIrB) isolated from patients (PT), healthcare workers (HCW) and hospital environment (HE) in a six-month screening program. From the 180 sampling points distributed in six hospital units, a total of 1,080 swabs were collected allowing the isolation of 390 HAIrB: 50.5% from HE, 42.6% from PT and 6.9% from HCW. Among the HAIrB, 32.6% were characterized as MDR and 38.7% as extended-spectrum cephalosporins resistant (ESC-R), showing no differences in the distribution between PT, HE and HCW. Carbapenem resistance (CARB-R) was detected for 17.7% of all HAIrB, being higher among Acinetobacter spp. isolates (36.5%), followed by Enterobacteriaceae (14.5%) and Pseudomonas spp. (11.8%). Except for the ICU, that revealed higher MDR, CARB-R and ESC-R rates, HAIrB-resistant profiles were similarly detected within the hospital units. Prevalence of blaKPC-like and blaCTX-M-1 β-lactamases-resistance genes was higher in K. pneumoniae and E. cloacae complex, while blaOXA-23-like and blaSPM-like were higher in A. baumannii and P. aeruginosa, respectively. This study reveals that the spreading of HAIrB within a hospital environment is higher than predicted, indicating that healthcare workers, hospital areas and equipment are key players on dissemination of MDR gram-negative bacteria and shows that an active surveillance program can provide precise understanding and direct actions towards control of HAI.

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