期刊
JOURNAL OF INFECTION
卷 83, 期 5, 页码 565-572出版社
W B SAUNDERS CO LTD
DOI: 10.1016/j.jinf.2021.08.039
关键词
Sars-CoV-2; COVID-19; Healthcare-associated infection; Community-onset infection
资金
- National Institute for Health Research (NIHR) Health Protection Research Unit (HPRU) in Healthcare-Associated Infections and Antimicrobial Resistance [NIHR200915]
- NIHR AMR award [NIHR200658]
In England, hospital-onset probable and definite cases accounted for 5.3% of all laboratory-confirmed COVID-19 cases, with community-onset community-acquired cases being the highest proportion. Hospital-associated SARS-CoV-2 infections were identified in single and multi-site hospital-based studies, with up to 1 in 6 infections among hospitalised patients being attributed to nosocomial transmission.
Objectives: Nosocomial transmission was an important aspect of SARS-CoV-1 and MERS-CoV outbreaks. Healthcare-associated SARS-CoV-2 infection has been reported in single and multi-site hospital-based studies in England, but not nationally. Methods: Admission records for all hospitals in England were linked to SARS-CoV-2 national test data for the period 01/03/2020 to 31/08/2020. Case definitions were: community-onset community-acquired, first positive test <14 days pre-admission, up to day 2 of admission; hospital-onset indeterminate healthcare-associated, first positive on day 3-7; hospital-onset probable healthcare-associated, first positive on day 8-14; hospital-onset definite healthcare-associated, first positive from day 15 of admission until discharge; community-onset possible healthcare-associated, first positive test <= 14 days post-discharge. Results: One-third (34.4%, 100,859/293,204) of all laboratory-confirmed COVID-19 cases were linked to a hospital record. Hospital-onset probable and definite cases represented 5.3% (15,564/293,204) of all laboratory-confirmed cases and 15.4% (15,564/100,859) of laboratory-confirmed cases among hospital patients. Community-onset community-acquired and community-onset possible healthcare-associated cases represented 86.5% (253,582/293,204) and 5.1% (14,913/293,204) of all laboratory-confirmed cases, respectively. Conclusions: Up to 1 in 6 SARS-CoV-2 infections among hospitalised patients with COVID-19 in England during the first 6 months of the pandemic could be attributed to nosocomial transmission, but these represent less than 1% of the estimated 3 million COVID-19 cases in this period. Crown Copyright (C) 2021 Published by Elsevier Ltd on behalf of The British Infection Association. All rights reserved.
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