SARS-CoV-2 nosocomial infection acquired in a French university hospital during the 1st wave of the Covid-19 pandemic, a prospective study

Abstract

Background In healthcare facilities, nosocomial transmissions of respiratory viruses are a major issue. SARS-CoV-2 is not exempt from nosocomial transmission. Our goals were to describe COVID-19 nosocomial cases during the first pandemic wave among patients in a French university hospital and compliance with hygiene measures. Methods We conducted a prospective observational study in Grenoble Alpes University Hospital from 01/03/2020 to 11/05/2020. We included all hospitalised patients with a documented SARS-CoV-2 diagnosis. Nosocomial case was defined by a delay of 5 days between hospitalisation and first symptoms. Hygiene measures were evaluated between 11/05/2020 and 22/05/2020. Lockdown measures were effective in France on 17/03/2020 and ended on 11/05/2020. Systematic wearing of mask was mandatory for all healthcare workers (HCW) and visits were prohibited in our institution from 13/03/2021 and for the duration of the lockdown period. Results Among 259 patients included, 14 (5.4%) were considered as nosocomial COVID-19. Median time before symptom onset was 25 days (interquartile range: 12–42). Eleven patients (79%) had risk factors for severe COVID-19. Five died (36%) including 4 deaths attributable to COVID-19. Two clusters were identified. The first cluster had 5 cases including 3 nosocomial acquisitions and no tested HCWs were positive. The second cluster had 3 cases including 2 nosocomial cases and 4 HCWs were positive. Surgical mask wearing and hand hygiene compliance were adequate for 95% and 61% of HCWs, respectively. Conclusions The number of nosocomial COVID-19 cases in our hospital was low. Compliance regarding mask wearing, hand hygiene and lockdown measures drastically reduced transmission of the virus. Monitoring of nosocomial COVID-19 cases during the first wave enabled us to determine to what extent the hygiene measures taken were effective and patients protected. Trial registration Study ethics approval was obtained retrospectively on 30 September 2020 (CECIC Rhône-Alpes-Auvergne, Clermont-Ferrand, IRB 5891).

Management of the Medico-Legal Dispute of Healthcare-Related SARS-CoV-2 Infections: Evaluation Criteria and Case Study in a Large University Hospital in Northwest Italy from 2020 to 2021

“…The results of this research project show that the infection in a hospital setting (after initial negative nasopharyngeal swab) mainly concerned male patients (57%); these data appear to be consistent with the data already published in the literature [ 2 , 22 , 23 ]. The average age was 81.83 years, higher than that described by other scientific studies [ 2 , 22 , 23 ].…”

“…The results of this research project show that the infection in a hospital setting (after initial negative nasopharyngeal swab) mainly concerned male patients (57%); these data appear to be consistent with the data already published in the literature [ 2 , 22 , 23 ]. The average age was 81.83 years, higher than that described by other scientific studies [ 2 , 22 , 23 ]. In addition, the average time between hospital entry and the positive nasopharyngeal swab (which roughly also corresponds to the evident clinical manifestation of the disease) was 12.86 days, with a median of 10 days.…”

Nosocomial septicemia in COVID-19 nosocomial K. pneumoniae, A. baumannii, and Elizabethkingia meningoseptica septicemia in a patient of COVID-19

“…As pointed out by Kwok et al, Bacterial co-infection is rare among hospitalized COVID-19 patients ( 1 ), and antibiotics should not be prescribed as a routine upon admission. Imprudent use of antibiotics predisposed the patients to multi-resistant nosocomial infections, especially for those with comorbid conditions, advanced age, using immunosuppressants, indwelling invasive devices, and prolonged hospitalizations ( 4 ). On the other hand, delay in adequate antibiotic coverage for patients with sepsis due to bacterial etiologies leads to catastrophic organ dysfunctions and increases the risk of mortality.…”

Risk factors of nosocomial Covid-19 in a French university hospital: a case- control study

“…In the literature, the proportion of nosocomial Covid-19 cases was comprised between 0% and 30.5% during the rst wave [4,18]. In our hospital, the rate of nosocomial Covid-19 was low during the rst wave, with 5.4% of nosocomial cases [19]. Only one study described a proportion of nosocomial Covid-19…”