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  • 1
    In: Antimicrobial Resistance & Infection Control, Springer Science and Business Media LLC, Vol. 11, No. 1 ( 2022-12)
    Abstract: We investigated the contribution of both occupational and community exposure for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among employees of a university-affiliated long-term care facility (LTCF), during the 1 st pandemic wave in Switzerland (March–June 2020). Methods We performed a nested analysis of a seroprevalence study among all volunteering LTCF staff to determine community and nosocomial risk factors for SARS-CoV-2 seropositivity using modified Poison regression. We also combined epidemiological and genetic sequencing data from a coronavirus disease 2019 (COVID-19) outbreak investigation in a LTCF ward to infer transmission dynamics and acquisition routes of SARS-CoV-2, and evaluated strain relatedness using a maximum likelihood phylogenetic tree. Results Among 285 LTCF employees, 176 participated in the seroprevalence study, of whom 30 (17%) were seropositive for SARS-CoV-2. Most (141/176, 80%) were healthcare workers (HCWs). Risk factors for seropositivity included exposure to a COVID-19 inpatient (adjusted prevalence ratio [aPR] 2.6; 95% CI 0.9–8.1) and community contact with a COVID-19 case (aPR 1.7; 95% CI 0.8–3.5). Among 18 employees included in the outbreak investigation, the outbreak reconstruction suggests 4 likely importation events by HCWs with secondary transmissions to other HCWs and patients. Conclusions These two complementary epidemiologic and molecular approaches suggest a substantial contribution of both occupational and community exposures to COVID-19 risk among HCWs in LTCFs. These data may help to better assess the importance of occupational health hazards and related legal implications during the COVID-19 pandemic.
    Type of Medium: Online Resource
    ISSN: 2047-2994
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 2666706-X
    SSG: 15,3
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  • 2
    In: BMJ Open, BMJ, Vol. 10, No. 9 ( 2020-09), p. e036342-
    Abstract: To determine the proportion of patients who received a treatment for Clostridioides difficile infection (CDI) among those presenting a discordant C. difficile diagnostic assay and to identify patient characteristics associated with the decision to treat CDI. Design Cross-sectional study. Setting Monocentric study in a tertiary care hospital, Geneva, Switzerland. Participants Among 4562 adult patients tested for C. difficile between March 2017 and March 2019, 208 patients with discordant tests’ results (positive nucleic acid amplification test (NAAT+)/negative enzyme immunoassay (EIA−)) were included. Main outcome measures Treatment for CDI. Results CDI treatment was administered in 147 (71%) cases. In multivariate analysis, an abdominal CT scan with signs of colitis (OR 14.7; 95% CI 1.96 to 110.8) was the only factor associated with CDI treatment. Conclusions The proportion of NAAT+/EIA− patients who received treatment questions the contribution of the EIA for the detection of toxin A/B after NAAT to limit overtreatment. Additional studies are needed to investigate if other factors are associated with the decision to treat.
    Type of Medium: Online Resource
    ISSN: 2044-6055 , 2044-6055
    Language: English
    Publisher: BMJ
    Publication Date: 2020
    detail.hit.zdb_id: 2599832-8
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