TY  - JOUR
A1  - Krüger, Sören
A1  - Leskien, Miriam
A1  - Schuller, Patricia
A1  - Prifert, Christiane
A1  - Weißbrich, Benedikt
A1  - Vogel, Ulrich
A1  - Krone, Manuel
T1  - Performance and feasibility of universal PCR admission screening for SARS‐CoV‐2 in a German tertiary care hospital
JF  - Journal of Medical Virology
N2  - Anamnestic screening of symptoms and contact history is applied to identify coronavirus disease 2019 (COVID‐19) patients on admission. However, asymptomatic and presymptomatic patients remain undetected although the viral load may be high. In this retrospective cohort study, all hospitalized patients who received polymerase chain reaction (PCR) admission testing from March 26th until May 24th, 2020 were included. Data on COVID‐19‐specific symptoms and contact history to COVID‐19 cases were retrospectively extracted from patient files and from contact tracing notes. The compliance to the universal testing protocol was high with 90%. Out of 6940 tested patients, 27 new severe acute respiratory syndrome coronavirus‐2 infections (0.4%) were detected. Seven of those COVID‐19 cases (26% of all new cases) were asymptomatic and had no positive contact history, but were identified through a positive PCR test. The number needed to identify an asymptomatic patient was 425 in the first wave of the epidemic, 1218 in the low incidence phase. The specificity of the method was above 99.9%. Universal PCR testing was highly accepted by staff as demonstrated by high compliance. The costs to detect one asymptomatic case in future studies need to be traded off against the costs and damage caused by potential outbreaks of COVID‐19.
KW  - admission screening
KW  - COVID‐19
KW  - infection control
KW  - SARS‐CoV‐2
KW  - testing strategy
Y1  - 2021
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-238971
VL  - 93
IS  - 5
SP  - 2890
EP  - 2898
ER  - 
TY  - JOUR
A1  - Stock, Nina Katharina
A1  - Petráš, Petr
A1  - Melter, Oto
A1  - Kapounová, Gabriela
A1  - Vopalková, Petra
A1  - Kubele, Jan
A1  - Vaniš, Václav
A1  - Tkadlec, Jan
A1  - Bukáčková, Eva
A1  - Machová, Ivana
A1  - Jindrák, Vlastimil
T1  - Importance of Multifaceted Approaches in Infection Control: A Practical Experience from an Outbreak Investigation
JF  - PLoS ONE
N2  - Background
This study presents the results of a multidisciplinary, nosocomial MRSA outbreak investigation in an 8-bed medical intensive care unit (ICU). The identification of seven MRSA positive patients in the beginning of 2014 led to the closure of the ward for several weeks. A multidisciplinary, retrospective investigation was initiated in order to identify the reason and the source for the outbreak, describe MRSA transmission in the department and identify limitations in infection control.

Methods
The investigation comprised an epidemiological description of MRSA cases from 2012 to 2014 and a characterization of MRSA isolates, including phage-, spa- and PFGE-typing. Additionally, MRSA screening was performed from the hospital staff and the environment. To identify the reason for the outbreak, work-related, psychological and behavioral factors were investigated by impartial audits and staff interviews.

Results
Thirty-one MRSA cases were registered during the study period, and 36 isolates were investigated. Molecular typing determined the outbreak strain (phage type 54/812, PFGE type A4, spa type t003) and identified the probable index case. Nasal carriage in one employee and a high environmental contamination with the outbreak strain was documented. Important gaps in nursing procedures and general management were identified. Elevated stress levels and communication problems preceded the outbreak. Compliance with hand hygiene and isolation procedures was evaluated as appropriate.

Conclusion
This study demonstrates the complexity of controlling hospital-associated infections. The combined use of different typing methods is beneficial for outbreak investigations. Psychological, behavioral and other work-related factors have an important impact on the spread of nosocomial pathogens. These factors should be addressed and integrated in routine infection control practice.
KW  - multifaceted approaches
KW  - infection control
KW  - Methicillin resistant Staphylococcus aureus
KW  - MRSA
Y1  - 2016
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-166891
VL  - 11
IS  - 6
ER  -