Observational studyEuropean journal of pediatrics2025
Characteristics of pediatric SARS-CoV-2 healthcare-associated infection outbreaks in Germany, 2020-2023: a retrospective observational study.
Observational study in European journal of pediatrics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Limiting healthcare-associated infections (HAI) SARS-CoV-2 transmission has been a global challenge. We assessed characteristics of pediatric SARS-CoV-2 HAI outbreaks to better understand HAI transmission in pediatric care. We analyzed PCR-confirmed SARS-CoV-2 outbreak cases notified through statutory surveillance, at case level and at outbreak level, in Germany between 24 February 2020 and 31 December 2023 to describe SARS-CoV-2 HAI outbreaks in pediatric care and compare them with non-pediatric outbreaks. Pediatric outbreaks included any outbreak in pediatric care or with > 50% of cases among patients aged < 18 years. We calculated age-disaggregated median monthly incidences of SARS-CoV-2 HAI outbreak cases per 100,000 hospitalizations using reimbursement data. Among 36,371 SARS-CoV-2 HAI hospital outbreak cases from 3191 outbreaks, we identified 25 pediatric outbreaks with 241 cases. Of 218 cases with case status information, 181 (83%) were healthcare workers (HCW) and 37 (17%) were patients < 18 years old. Among all 241 cases, five (2%) were severe including one death case whereas 2580 (7%) of non-pediatric HAI cases were severe and 2736 (8%) deaths. Age-disaggregated median monthly outbreak case incidence < 18 years (0.3/100,000 hospitalizations; range 0.1-7.6) was markedly lower than among the non-pediatric age group of 18-59-year olds (14.8/100,000 hospitalizations; range 0.1-215.7).
conclusionOur results suggest limited SARS-CoV-2 HAI transmission in pediatric care. The high proportion of cases among HCW in pediatric outbreaks underlines the need to protect HCW from infections to further limit HAI transmission. Our findings highlight the value of outbreak surveillance for monitoring HAI transmission patterns in vulnerable sub-groups such as pediatric patients. WHAT IS KNOWN: • Children and adolescents experience less severe SARS-CoV-2 illness. • Pediatric care poses unique infection prevention and control challenges. WHAT IS NEW: • Pediatric outbreaks were very rare with few severe cases suggesting that pediatric care was less affected by SARS-CoV-2 outbreaks. • Most cases in pediatric outbreaks occurred among healthcare workers pointing to the need to protect HCW from infections and a limited role of pediatric patients and caregivers.
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