Increased risk of SARS-CoV-2 infection in staff working across different care homes enchanced CoVID-19 outbreak investigations in London care Homes

Source avec lien : Journal of Infection, (Prépublication), 7/29/2020. 10.1016/j.jinf.2020.07.027

Contexte Les maisons de soins ont été touchées de manière disproportionnée par la pandémie de COVID-19 et continuent de subir des flambées importantes même lorsque les taux d’infection de la communauté sont en baisse, représentant ainsi d’importantes poches de transmission. Nous avons évalué les facteurs de risque professionnels d’infection par le CoV-2 du SRAS chez le personnel de six maisons de soins ayant connu une épidémie de COVID-19 au plus fort de la pandémie à Londres, en Angleterre. Méthodes Le personnel des maisons de soins a été testé pour l’infection par le SRAS-COV-2 par RT-PCR et on lui a demandé de signaler tout symptôme, ses contacts avec les résidents et s’il travaillait dans différentes maisons de soins. Le séquençage du génome entier (WGS) a été effectué sur les échantillons positifs à la RT-PCR.

Background Care homes have been disproportionately affected by the COVID-19 pandemic and continue to suffer large outbreaks even when community infection rates are declining, thus representing important pockets of transmission. We assessed occupational risk factors for SARS-CoV-2 infection among staff in six care homes experiencing a COVID-19 outbreak during the peak of the pandemic in London, England. Methods Care home staff were tested for SARS-COV-2 infection by RT-PCR and asked to report any symptoms, their contact with residents and if they worked in different care homes. Whole genome sequencing (WGS) was performed on RT-PCR positive samples. Results In total, 53 (21%) of 254 staff were SARS-CoV-2 positive but only 12/53 (23%) were symptomatic. Among staff working in a single care home, SARS-CoV-2 positivity was 15% (2/13), 16% (7/45) and 18% (30/169) in those reporting no, occasional and regular contact with residents. In contrast, staff working across different care homes (14/27, 52%) had a 3.0-fold (95% CI, 1.9–4.8; P<0.001) higher risk of SARS-CoV-2 positivity than staff working in single care homes (39/227, 17%). WGS identified SARS-CoV-2 clusters involving staff only, including some that included staff working across different care homes. Conclusions SARS-CoV-2 positivity was significantly higher among staff working across different care homes than those who were working in the same care home. We found local clusters of SARS-CoV-2 infection between staff only, including those with minimal resident contact. Infection control should be extended for all contact, including those between staff, whilst on care home premises. Lisez l’article

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