Whole-genome Sequencing to Track Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Transmission in Nosocomial Outbreaks
- PMID: 32954414
- PMCID: PMC7543366
- DOI: 10.1093/cid/ciaa1433
Whole-genome Sequencing to Track Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Transmission in Nosocomial Outbreaks
Abstract
Background: During the first wave of the coronavirus disease 2019 (COVID-19) pandemic, outbreaks of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in healthcare institutions posed a significant problem. Due to limited evidence, guidance on appropriate infection prevention and control (IPC) measures such as the wearing of face masks varied. Here, we applied whole virus genome sequencing (WvGS) to analyze transmission routes of SARS-CoV-2 in hospital-acquired (HA) COVID-19.
Methods: An investigation was undertaken for all HA cases of COVID-19 from March to April 2020. Fifty SARS-CoV-2 samples were analysed by WvGS and their phylogenetic relationship established.
Results: WvGS identified transmission events previously undetected by epidemiological analysis and provided evidence for SARS-CoV-2 transmission between healthcare workers (HCW) and patients and among HCW themselves. The majority of HA COVID-19 cases occurred in patients highly dependent on nursing care, suggesting the likely route of transmission was by close contact or droplet, rather than aerosol, transmission. Mortality among HA COVID-19 infections was recorded as 33%.
Conclusions: This study provides evidence that SARS-CoV-2 transmission occurs from symptomatic and asymptomatic HCWs to patients. Interventions including comprehensive screening of HCWs for COVID-19 symptoms, PCR testing of asymptomatic HCWs upon identification of HA cases and implementation of universal use of surgical masks for all clinical care is indicated to prevent viral transmission. Our study highlights the importance of close collaboration between guidance bodies and frontline IPC experts for developing control measures in an emergency pandemic situation caused by a virus with undefined transmission modus.
Keywords: infection prevention and control; nosocomial outbreaks; severe acute respiratory syndrome coronavirus 2; whole virus genome sequencing.
�� The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.
Similar articles
-
Nosocomial Outbreak of SARS-CoV-2 in a "Non-COVID-19" Hospital Ward: Virus Genome Sequencing as a Key Tool to Understand Cryptic Transmission.Viruses. 2021 Apr 1;13(4):604. doi: 10.3390/v13040604. Viruses. 2021. PMID: 33916205 Free PMC article.
-
Explosive nosocomial outbreak of SARS-CoV-2 in a rehabilitation clinic: the limits of genomics for outbreak reconstruction.J Hosp Infect. 2021 Nov;117:124-134. doi: 10.1016/j.jhin.2021.07.013. Epub 2021 Aug 27. J Hosp Infect. 2021. PMID: 34461177 Free PMC article.
-
Combining epidemiological data and whole genome sequencing to understand SARS-CoV-2 transmission dynamics in a large tertiary care hospital during the first COVID-19 wave in The Netherlands focusing on healthcare workers.Antimicrob Resist Infect Control. 2023 May 10;12(1):46. doi: 10.1186/s13756-023-01247-7. Antimicrob Resist Infect Control. 2023. PMID: 37165456 Free PMC article.
-
Nosocomial transmission and outbreaks of coronavirus disease 2019: the need to protect both patients and healthcare workers.Antimicrob Resist Infect Control. 2021 Jan 6;10(1):7. doi: 10.1186/s13756-020-00875-7. Antimicrob Resist Infect Control. 2021. PMID: 33407833 Free PMC article. Review.
-
[Respiratory and Facial Protection: Current Perspectives in the Context of the COVID-19 Pandemic].Acta Med Port. 2020 Sep 1;33(9):583-592. doi: 10.20344/amp.14108. Epub 2020 Jun 19. Acta Med Port. 2020. PMID: 32568064 Review. Portuguese.
Cited by
-
Multiple introductions of monkeypox virus to Ireland during the international mpox outbreak, May 2022 to October 2023.Euro Surveill. 2024 Apr;29(16):2300505. doi: 10.2807/1560-7917.ES.2024.29.16.2300505. Euro Surveill. 2024. PMID: 38639093 Free PMC article.
-
COVID-19 outbreak among employees of a German hospital: risk factor analysis based on a follow-up questionnaire and seroprevalence.Infection. 2024 Mar 15. doi: 10.1007/s15010-024-02220-1. Online ahead of print. Infection. 2024. PMID: 38488974
-
Viral genome sequencing to decipher in-hospital SARS-CoV-2 transmission events.Sci Rep. 2024 Mar 8;14(1):5768. doi: 10.1038/s41598-024-56162-7. Sci Rep. 2024. PMID: 38459123 Free PMC article.
-
The utility of whole-genome sequencing to inform epidemiologic investigations of SARS-CoV-2 clusters in acute-care hospitals.Infect Control Hosp Epidemiol. 2024 Feb;45(2):144-149. doi: 10.1017/ice.2023.274. Epub 2023 Dec 22. Infect Control Hosp Epidemiol. 2024. PMID: 38130169 Free PMC article.
-
Tracking Risk Factors Related to an Outbreak of COVID-19 Among Healthcare Workers in a General Medicine Ward.Cureus. 2023 Nov 7;15(11):e48429. doi: 10.7759/cureus.48429. eCollection 2023 Nov. Cureus. 2023. PMID: 37954630 Free PMC article.
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Medical
Miscellaneous