Nosocomial or not? A combined epidemiological and genomic investigation to understand hospital-acquired COVID-19 infection on an elderly care ward.



Wenlock, RD ORCID: 0000-0001-7510-0821, Tausan, M, Mann, R, Garr, W, Preston, R, Arnold, A, Hoban, J, Webb, L, Quick, C, Beckett, A ORCID: 0000-0003-4948-1004
et al (show 10 more authors) (2021) Nosocomial or not? A combined epidemiological and genomic investigation to understand hospital-acquired COVID-19 infection on an elderly care ward. Infection prevention in practice, 3 (3). 100165-.

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Abstract

<h4>Background</h4>COVID-19 has the potential to cause outbreaks in hospitals. Given the comorbid and elderly cohort of patients hospitalized, hospital-acquired COVID-19 infection is often fatal. Pathogen genome sequencing is becoming increasingly important in infection prevention and control (IPC).<h4>Aim</h4>To inform the understanding of in-hospital SARS-CoV-2 transmission in order to improve IPC practices and to inform the future development of virological testing for IPC.<h4>Methods</h4>Patients detected COVID-19 positive by polymerase chain reaction on Ward A in April and May 2020 were included with contact tracing to identify other potential cases. Genome sequencing was undertaken for a subgroup of cases. Epidemiological, genomic, and cluster analyses were performed to describe the epidemiology and to identify factors contributing to the outbreak.<h4>Findings</h4>Fourteen cases were identified on Ward A. Contact tracing identified 16 further patient cases; in addition, eight healthcare workers (HCWs) were identified as being COVID-19 positive through a round of asymptomatic testing. Genome sequencing of 16 of these cases identified viral genomes differing by two single nucleotide polymorphisms or fewer, with further cluster analysis identifying two groups of infection (a five-person group and a six-person group).<h4>Conclusion</h4>Despite the temporal relationship of cases, genome sequencing identified that not all cases shared transmission events. However, 11 samples were found to be closely related and these likely represented in-hospital transmission. This included three HCWs, thereby confirming transmission between patients and HCWs.

Item Type: Article
Uncontrolled Keywords: COVID-19 Genomics UK (COG-UK) consortium
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Infection, Veterinary and Ecological Sciences
Depositing User: Symplectic Admin
Date Deposited: 10 Jan 2023 16:04
Last Modified: 16 Dec 2023 03:36
DOI: 10.1016/j.infpip.2021.100165
Open Access URL: http://dx.doi.org/10.1016/j.infpip.2021.100165
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3166982