P109 Infection control policies during the COVID-19 pandemic were effective in limiting morbidity and mortality associated with nosocomial viral transmission at a large NHS respiratory department

H. Aung, K. Kyaw, R. Free, J. Blount, D. Jenkins, J. Tang, S. Range, P. Haldar, G. Woltmann
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Abstract

IntroductionPrevention of nosocomial transmission was a priority for NHS hospital teams during the SARS-COV-2 pandemic. However, infection control policies were developed in the face of uncertainty about duration of infectivity, routes of transmission, and safety of shared admission spaces. We retrospectively reviewed all hospital admissions to the University Hospitals of Leicester (UHL) respiratory department, which managed more than 30% of UHL patients with a diagnosis of COVID-19 between March 2020 and March 2021to determine the proportion of cases with laboratory evidence of healthcare associated infection (HCAI) and mortality within 28 days of PCR conversionMethodsThis was a retrospective cohort study performed using a bespoke database collating COVID-19 throat swab (TS) PCR results for UHL (COVTRACK). Nosocomial transmission was identified by demonstrating PCR conversions during admission and categorized into definite (conversion time > 14 days) or probable (conversion time 8–14 days). In depth records based analysis was undertaken for patients admitted to respiratory medicine (RM) and deceased within 28 days after conversion.ResultsOut of 10485 patients admitted to the Respiratory Department at UHL, 2054 (19.6%) were COVID-19 spell positive, including 57 with probable (41) or definite HCAI (16). 23 patients (7 with definite HCAI) died within 28 days of PCR conversion (0.22%, of total admitted, 1.1% of COVID19 positive), with 21 (91%) deaths in the 2nd wave. Compared with non-COVID admissions not acquiring nosocomial infection, HCAI was significantly associated with older age (mean difference (95%CI) 11.5 (7.5–15.5) years), length of stay (median LOS 18 Vs 1 day) and multiple ward occupancy (median 3 vs 1 ward);all analyses p<0.001.DiscussionOur analysis suggests HCAI with SARS-COV-2 contributed a very small fraction of COVID-19 related morbidity and mortality at our department and in the majority the trajectory of care was not changed. Despite the high numbers of highly infectious cases during the 1st and 2nd wave, we successfully implemented a suite of infection control measures that effectively mitigated risk. High throughput in admission areas, multiple ward moves, and prolonged hospital stay were significant risk factors associated with HCAI.
P109在一家大型NHS呼吸科,COVID-19大流行期间的感染控制政策有效地限制了与院内病毒传播相关的发病率和死亡率
在SARS-COV-2大流行期间,预防院内传播是NHS医院团队的优先事项。然而,感染控制政策是在面对传染性持续时间、传播途径和共享入院空间安全性的不确定性时制定的。我们回顾性回顾了莱斯特大学医院(UHL)呼吸科的所有住院病例。该研究在2020年3月至2021年3月期间管理了超过30%的诊断为COVID-19的UHL患者,以确定在PCR转换后28天内具有卫生保健相关感染(HCAI)实验室证据的病例比例和死亡率。方法本研究是一项回顾性队列研究,使用定制数据库整理COVID-19咽喉拭子(TS) PCR结果UHL (COVTRACK)。入院时通过PCR转化鉴定院内传播,并将其分为明确(转化时间> 14天)和可能(转化时间8-14天)两类。对入院呼吸内科(RM)并在转换后28天内死亡的患者进行了深度记录分析。结果在我院呼吸科就诊的10485例患者中,2054例(19.6%)为COVID-19阳性,其中可能或明确HCAI 57例(41例)。23例(确诊HCAI 7例)在PCR转化后28天内死亡(占入院总人数的0.22%,阳性1.1%),第二波死亡21例(91%)。与未获得医院感染的非covid入院患者相比,HCAI与年龄(平均差异(95%CI) 11.5(7.5-15.5)岁)、住院时间(中位LOS 18 Vs 1天)和多个病房占用(中位3 Vs 1个病房)显著相关,所有分析p<0.001。我们的分析表明,HCAI合并SARS-COV-2在我们科的COVID-19相关发病率和死亡率中只占很小的一部分,并且在大多数情况下,护理轨迹没有改变。尽管在第一波和第二波期间出现了大量高传染性病例,但我们成功实施了一套感染控制措施,有效降低了风险。入院区高吞吐量、多次病房转移和住院时间延长是与HCAI相关的重要危险因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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