Association of institutional masking policies with healthcare-associated SARS-CoV-2 infections in Swiss acute care hospitals during the BA.4/5 wave (CH-SUR study): a retrospective observational study.

IF 4.8 2区医学 Q1 INFECTIOUS DISEASES

Antimicrobial Resistance and Infection Control Pub Date : 2024-06-18 DOI:10.1186/s13756-024-01422-4

Tamara Dörr, Sabine Güsewell, Domenica Flury, Maria Süveges, Camille Beatrice Gaza Valera, Sara Botero-Mesa, Marie-Céline Zanella, Anne Iten, Carlo Balmelli, Nicolas Troillet, Sarah Tschudin-Sutter, Peter W Schreiber, Philipp Jent, Lauro Damonti, Rami Sommerstein, Lea Portmann, Danielle Vuichard-Gysin, Alexia Cusini, Yvonne Nussbaumer-Ochsner, Ulrich Heininger, Christoph Berger, Petra Zimmermann, Céline Gardiol, Olivia Keiser, Matthias Schlegel, Philipp Kohler, Stefan P Kuster

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引用次数: 0

Abstract

Background: In the initial phase of the SARS-CoV-2 pandemic, masking has been widely accepted in healthcare institutions to mitigate the risk of healthcare-associated infection. Evidence, however, is still scant and the role of masks in preventing healthcare-associated SARS-CoV-2 acquisition remains unclear.We investigated the association of variation in institutional mask policies with healthcare-associated SARS-CoV-2 infections in acute care hospitals in Switzerland during the BA.4/5 2022 wave.

Methods: SARS-CoV-2 infections in hospitalized patients between June 1 and September 5, 2022, were obtained from the "Hospital-based surveillance of COVID-19 in Switzerland"-database and classified as healthcare- or community-associated based on time of disease onset. Institutions provided information regarding institutional masking policies for healthcare workers and other prevention policies. The percentage of healthcare-associated SARS-CoV-2 infections was calculated per institution and per type of mask policy. The association of healthcare-associated SARS-CoV-2 infections with mask policies was tested using a negative binominal mixed-effect model.

Results: We included 2'980 SARS-CoV-2 infections from 13 institutions, 444 (15%) were classified as healthcare-associated. Between June 20 and June 30, 2022, six (46%) institutions switched to a more stringent mask policy. The percentage of healthcare-associated infections subsequently declined in institutions with policy switch but not in the others. In particular, the switch from situative masking (standard precautions) to general masking of HCW in contact with patients was followed by a strong reduction of healthcare-associated infections (rate ratio 0.39, 95% CI 0.30-0.49). In contrast, when compared across hospitals, the percentage of health-care associated infections was not related to mask policies.

Conclusions: Our findings suggest switching to a more stringent mask policy may be beneficial during increases of healthcare-associated SARS-CoV-2 infections at an institutional level.

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BA.4/5疫情期间瑞士急症护理医院中机构掩蔽政策与医护人员相关 SARS-CoV-2 感染的关系（CH-SUR 研究）：一项回顾性观察研究。

背景：在SARS-CoV-2大流行的初期阶段，医疗机构普遍接受戴口罩来降低医疗相关感染的风险。我们研究了在 BA.4/5 2022 疫潮期间，机构口罩政策的变化与瑞士急诊医院中与医疗相关的 SARS-CoV-2 感染之间的关系：从 "瑞士 COVID-19 医院监测 "数据库中获取了 2022 年 6 月 1 日至 9 月 5 日期间住院患者中的 SARS-CoV-2 感染病例，并根据发病时间将其分为医疗机构相关型和社区相关型。医疗机构提供了有关医护人员的机构掩蔽政策和其他预防政策的信息。每个机构和每种口罩政策都计算了与医疗保健相关的 SARS-CoV-2 感染百分比。使用负二项式混合效应模型检验了医护人员感染 SARS-CoV-2 与口罩政策之间的关系：我们纳入了 13 家机构的 2,980 例 SARS-CoV-2 感染病例，其中 444 例（15%）被归类为医疗保健相关感染病例。在 2022 年 6 月 20 日至 6 月 30 日期间，6 所院校（46%）改用了更严格的口罩政策。随后，政策转换的机构中医疗相关感染的比例有所下降，但其他机构的比例没有下降。特别是，与患者接触的医护人员从情景口罩（标准预防措施）转为一般口罩后，医护相关感染率大幅下降（比率比为 0.39，95% CI 为 0.30-0.49）。与此相反，在对不同医院进行比较时，医疗相关感染的比例与口罩政策无关：我们的研究结果表明，改用更严格的口罩政策可能有益于机构层面的 SARS-CoV-2 医疗相关感染的增加。

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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来源期刊

Antimicrobial Resistance and Infection Control PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -INFECTIOUS DISEASES

CiteScore

9.70

自引率

3.60%

发文量

140

审稿时长

13 weeks

期刊介绍： Antimicrobial Resistance and Infection Control is a global forum for all those working on the prevention, diagnostic and treatment of health-care associated infections and antimicrobial resistance development in all health-care settings. The journal covers a broad spectrum of preeminent practices and best available data to the top interventional and translational research, and innovative developments in the field of infection control.