Evidence map›Paper›PMID 37085891›Full record

ArticleAntimicrobial resistance and infection control2023

A systematic outbreak investigation of SARS-CoV-2 transmission clusters in a tertiary academic care center.

Matthias von Rotz, Richard Kuehl, Ana Durovic, Sandra Zingg, Anett Apitz, Fanny Wegner, Helena M B Seth-Smith, Tim Roloff, Karoline Leuzinger, Hans H Hirsch and 8 more

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Article in Antimicrobial resistance and infection control, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

Matthias von RotzDivision of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, University of Basel, Petersgraben 4, 4031, Basel, Switzerland.
Richard KuehlDivision of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, University of Basel, Petersgraben 4, 4031, Basel, Switzerland.
Ana DurovicSwiss Tropical and Public Health Institute, Basel, Switzerland.
Sandra ZinggIntensive Care Unit, University Hospital Basel, University of Basel, Basel, Switzerland.
Anett ApitzEmployee Health Service, University Hospital Basel, Basel, Switzerland.
Fanny WegnerDivision of Clinical Bacteriology and Mycology, University Hospital Basel, University of Basel, Basel, Switzerland.
Helena M B Seth-SmithDivision of Clinical Bacteriology and Mycology, University Hospital Basel, University of Basel, Basel, Switzerland.
Tim RoloffDivision of Clinical Bacteriology and Mycology, University Hospital Basel, University of Basel, Basel, Switzerland.
Karoline LeuzingerClinical Virology, Laboratory Medicine, University Hospital Basel, University of Basel, Basel, Switzerland.
Hans H HirschDivision of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, University of Basel, Petersgraben 4, 4031, Basel, Switzerland.
Sabine KusterDivision of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, University of Basel, Petersgraben 4, 4031, Basel, Switzerland.
Manuel BattegayDivision of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, University of Basel, Petersgraben 4, 4031, Basel, Switzerland.
Luigi MarianiDepartment of Neurosurgery, University Hospital Basel, University of Basel, Basel, Switzerland.
Stefan SchaerenDepartment of Traumatology and Orthopedics, University Hospital Basel, University of Basel, Basel, Switzerland.
Stefano BassettiDivision of Internal Medicine, University Hospital Basel, University of Basel, Basel, Switzerland.
Florian Banderet-UglioniEmployee Health Service, University Hospital Basel, Basel, Switzerland.
Adrian EgliDivision of Clinical Bacteriology and Mycology, University Hospital Basel, University of Basel, Basel, Switzerland.
Sarah Tschudin-SutterDivision of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, University of Basel, Petersgraben 4, 4031, Basel, Switzerland. sarah.tschudin@usb.ch.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWe sought to decipher transmission pathways in healthcare-associated infections with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) within our hospital by epidemiological work-up and complementary whole genome sequencing (WGS). We report the findings of the four largest epidemiologic clusters of SARS-CoV-2 transmission occurring during the second wave of the pandemic from 11/2020 to 12/2020.

methodsAt the University Hospital Basel, Switzerland, systematic outbreak investigation is initiated at detection of any nosocomial case of SARS-CoV-2 infection, as confirmed by polymerase chain reaction, occurring more than five days after admission. Clusters of nosocomial infections, defined as the detection of at least two positive patients and/or healthcare workers (HCWs) within one week with an epidemiological link, were further investigated by WGS on respective strains.

resultsThe four epidemiologic clusters included 40 patients and 60 HCWs. Sequencing data was available for 70% of all involved cases (28 patients and 42 HCWs), confirmed epidemiologically suspected in house transmission in 33 cases (47.1% of sequenced cases) and excluded transmission in the remaining 37 cases (52.9%). Among cases with identical strains, epidemiologic work-up suggested transmission mainly through a ward-based exposure (24/33, 72.7%), more commonly affecting HCWs (16/24, 66.7%) than patients (8/24, 33.3%), followed by transmission between patients (6/33, 18.2%), and among HCWs and patients (3/33, 9.1%, respectively two HCWs and one patient).

conclusionsPhylogenetic analyses revealed important insights into transmission pathways supporting less than 50% of epidemiologically suspected SARS-CoV-2 transmissions. The remainder of cases most likely reflect community-acquired infection randomly detected by outbreak investigation. Notably, most transmissions occurred between HCWs, possibly indicating lower perception of the risk of infection during contacts among HCWs.

Indexed as

COVID-19Cross InfectionDisease OutbreaksHumansPhylogenySARS-CoV-2Tertiary Care CentersCOVID-19Epidemiologic clusterNosocomial outbreaksOutbreak investigationSARS-CoV-2 clusterWhole genome sequencing

Identifiers

PMID37085891
PMCPMC10119817

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.