Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 6, 2022; 10(34): 12559-12565
Published online Dec 6, 2022. doi: 10.12998/wjcc.v10.i34.12559
Nosocomial infection and spread of SARS-CoV-2 infection among hospital staff, patients and caregivers
Chih-Chien Cheng, Li-Yun Fann, Yi-Chang Chou, Chia-Chen Liu, Hsiao-Yun Hu, Dachen Chu
Chih-Chien Cheng, Department of Education and Research, Taipei City Hospital, Taipei 116009, Taiwan
Li-Yun Fann, Department of Nursing, Taipei City Hospital, Taipei 106243, Taiwan
Yi-Chang Chou, Hsiao-Yun Hu, Dachen Chu, Department of Education and Research, Taipei City Hospital, Taipei 106109, Taiwan
Chia-Chen Liu, School of Medicine, College of Medicine, Fu Jen Catholic University, Taipei 106109, Taiwan
Author contributions: Cheng CC, Fann LY, Chou YC, Liu CC, Hu HY, Chu D designed research; Cheng CC, Fann LY performed research; Cheng CC, Chou YC, Liu CC contributed analytic tools; Cheng CC, Chou YC, Liu CC, Hu HY, Chu D wrote the paper; all author agreed and proven this revised article.
Institutional review board statement: The study was approved by the hospital’s institutional review board (IRB), with IRB number TCHIRB-11101009-E. All investigations were carried out in compliance with relevant laws and guidelines, and with the ethical standards of the Declaration of Helsinki.
Conflict-of-interest statement: There are no conflicts of interest to report.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Chih-Chien Cheng, MD, PhD, Doctor, Professor, Department of Education and Research, Taipei City Hospital, No. 10 Sec 4, RenAi Road, Daan Dist, Taipei 10619, Taiwan. dxo90@tpech.gov.tw
Received: September 30, 2022
Peer-review started: September 30, 2022
First decision: October 13, 2022
Revised: October 18, 2022
Accepted: November 7, 2022
Article in press: November 7, 2022
Published online: December 6, 2022
Abstract
BACKGROUND

There are difficulties in diagnosing nosocomial transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in hospital settings. Furthermore, mortality of cases of nosocomial infection (NI) with SARS-CoV-2 is higher than that of the general infected population. In the early stage of the pandemic in Taiwan, as patients were not tested for SARS-CoV-2 at admission, NIs often go undetected. Strictly applying the systematic polymerase chain reaction (PCR) screening, as a standard infection control measure was subsequently implemented to reduce NI incidence. However, evidence on risk factors for SARS-CoV-2 NIs among healthcare workers (HCWs) and caregivers is limited.

AIM

To assess NI incidence of SARS-CoV-2 among hospital staff, hospitalized patients, and caregivers, and the transmission routes of clusters of infection.

METHODS

This descriptive retrospective analysis at our hospital from May 15 to August 15, 2021 included data on 132 SARS-CoV-2 NIs cases among hospital staff, inpatients, and caregivers who previously tested negative but subsequently identified with a positive SARS-CoV-2 reverse transcriptase-PCR (RT-PCR) test results, or a hospital staff who tested positive following routine SARS-CoV-2 RT-PCR test. Chi-square tests were performed to compare the differences between hospital staff and private caregivers, and between clusters and sporadic infections.

RESULTS

Overall, 9149 patients and 2005 hospital staff members underwent routine SARS-CoV-2 RT-PCR testing, resulting in 12 confirmed cluster and 23 sporadic infections. Among the index cases of the clusters, three (25%) cases were among hospital staff and nine (75%) cases were among other contacts. Among sporadic infections, 21 (91%) cases were among hospital staff and two (9%) cases were among other contacts (P < 0.001). There was an average of 8.08 infections per cluster. The secondary cases of cluster infection were inpatients (45%), hospital staff (30%), and caregivers (25%). Private caregivers constituted 27% and 4% of the clusters and sporadic infections, respectively (P = 0.024); 92.3% of them were infected in the clusters. The mortality rate was 0.0%.

CONCLUSION

The incidence of SARS-CoV-2 infection was relatively high among private caregivers, indicating a need for infection control education in this group, such as social distancing, frequent hand-washing, and wearing PPE.

Keywords: COVID-19, SARS CoV-2, Cross infection, Incidence, Retrospective studies, Infection control

Core Tip: Patients were more likely to acquire a nosocomial infection than hospital staff and caregivers. Private caregivers tended to be part of clusters of infection, due to social interaction. The incidence of severe acute respiratory syndrome coronavirus 2 infection was relatively high among private caregivers, indicating a need for infection control education in this group.