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. 2021 Apr:110:178-183.
doi: 10.1016/j.jhin.2021.02.005. Epub 2021 Feb 8.

Transmission of SARS-CoV-2 among healthcare workers and patients in a teaching hospital in the Netherlands confirmed by whole-genome sequencing

S Paltansing  1 , R S Sikkema  2 , S J de Man  3 , M P G Koopmans  2 , B B Oude Munnink  2 , P de Man  3
Affiliations

Transmission of SARS-CoV-2 among healthcare workers and patients in a teaching hospital in the Netherlands confirmed by whole-genome sequencing

S Paltansing et al. J Hosp Infect. 2021 Apr.

Abstract

Aim: To investigate the sources of infection among healthcare workers (HCWs) and patients in a teaching hospital in the Netherlands during the early stages of the coronavirus disease 2019 (COVID-19) pandemic using epidemiological and whole-genome sequencing data.

Methods: From 3rd April to 11th May 2020, 88 HCWs and 215 patients were diagnosed with COVID-19. Whole-genome sequences were obtained for 30 HCWs and 20 patients.

Results: Seven and 11 sequence types were identified in HCWs and patients, respectively. Cluster A was the most common sequence type, detected in 23 (77%) HCWs; of these, 14 (61%) had direct patient contact and nine (39%) had indirect patient contact. In addition, seven patients who were not hospitalized in the COVID-19 cohort isolation ward who became positive during their admission were infected with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) cluster A. Following universal masking of all HCWs and emphasis on physical distancing during meals and breaks, no further evidence was found for patient-to-HCW or HCW-to-HCW transmission or vice versa.

Conclusion: The finding that patients and HCWs were infected with SARS-CoV-2 cluster A suggests both HCW-to-HCW and HCW-to-patient transmission.

Keywords: COVID-19; Healthcare worker; Molecular typing; Outbreak; SARS-CoV-2; WGS.

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Figures

Figure 1
Figure 1
Timeline of 88 healthcare workers (HCWs) and 20 admitted patients with laboratory-confirmed severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) with their corresponding sequence cluster type. PCR, polymerase chain reaction; COVID-19, coronavirus disease 2019.
Figure 2
Figure 2
Maximum-likelihood phylogeny of all complete genomes of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) strains in the Netherlands (5th June 2020) and focusing on the SARS-CoV-2 strains described in this study. The scale indicates the number of nucleotide substitutions per site. Patient sequences are shown in blue and healthcare worker sequences are shown in red.
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