Infection prevention and control risk factors for SARS-CoV-2 infection in health workers: a global, multi-centre, case–control study

IF 3.1 3区医学 Q1 INFECTIOUS DISEASES Journal of Hospital Infection Pub Date : 2025-01-01 Epub Date: 2024-09-20 DOI:10.1016/j.jhin.2024.04.031

A. Cassini , Y. Mo , A. Simniceanu , G. Gon , B.J. Cowling , B. Allegranzi

{"title":"Infection prevention and control risk factors for SARS-CoV-2 infection in health workers: a global, multi-centre, case–control study","authors":"A. Cassini , Y. Mo , A. Simniceanu , G. Gon , B.J. Cowling , B. Allegranzi","doi":"10.1016/j.jhin.2024.04.031","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Health workers were at higher risk for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection during the coronavirus disease 2019 (COVID-19) pandemic due to occupational risk factors. This study aimed to characterize these risk factors as part of the World Health Organization (WHO) Unity Studies initiative.</div></div><div><h3>Methods</h3><div>This global, multi-centre, nested, case–control study was conducted in 121 healthcare facilities in 21 countries. Cases were health workers who tested positive for SARS-CoV-2 infection with documented occupational exposure to COVID-19 patients in the 14 days pre-enrolment. Controls were enrolled from the same facilities with similar exposure but negative serology. Case and control status was confirmed with serological testing at baseline and after 3–4 weeks. Demographic and infection risk factor data were collected using structured questionnaires.</div></div><div><h3>Findings</h3><div>Between June 2020 and December 2021, data were obtained for 1213 cases and 1844 controls. Risk of SARS-CoV-2 infection was associated with non-adherence to personal protective equipment (PPE) guidelines [adjusted odds ratio (aOR) 1.67, 95% confidence interval (CI) 1.32–2.12] and not performing hand hygiene consistently after patient contact (aOR 2.52, 95% CI 1.72–3.68). Direct close contact with COVID-19 patients was also associated with increased risk of SARS-CoV-2 infection, particularly during prolonged contact (>15 min). Items associated with lower risk of SARS-CoV-2 infection were use of a respirator during aerosol-generating procedures; and use of gloves, and a gown or coverall during contact with contaminated materials/surfaces. No difference was observed between health workers using respirators vs surgical masks for routine care.</div></div><div><h3>Conclusion</h3><div>Appropriate implementation of infection prevention and control measures and use of PPE remain a priority to protect health workers from SARS-CoV-2 infection.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"155 ","pages":"Pages 40-50"},"PeriodicalIF":3.1000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Hospital Infection","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0195670124003116","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/9/20 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Health workers were at higher risk for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection during the coronavirus disease 2019 (COVID-19) pandemic due to occupational risk factors. This study aimed to characterize these risk factors as part of the World Health Organization (WHO) Unity Studies initiative.

Methods

This global, multi-centre, nested, case–control study was conducted in 121 healthcare facilities in 21 countries. Cases were health workers who tested positive for SARS-CoV-2 infection with documented occupational exposure to COVID-19 patients in the 14 days pre-enrolment. Controls were enrolled from the same facilities with similar exposure but negative serology. Case and control status was confirmed with serological testing at baseline and after 3–4 weeks. Demographic and infection risk factor data were collected using structured questionnaires.

Findings

Between June 2020 and December 2021, data were obtained for 1213 cases and 1844 controls. Risk of SARS-CoV-2 infection was associated with non-adherence to personal protective equipment (PPE) guidelines [adjusted odds ratio (aOR) 1.67, 95% confidence interval (CI) 1.32–2.12] and not performing hand hygiene consistently after patient contact (aOR 2.52, 95% CI 1.72–3.68). Direct close contact with COVID-19 patients was also associated with increased risk of SARS-CoV-2 infection, particularly during prolonged contact (>15 min). Items associated with lower risk of SARS-CoV-2 infection were use of a respirator during aerosol-generating procedures; and use of gloves, and a gown or coverall during contact with contaminated materials/surfaces. No difference was observed between health workers using respirators vs surgical masks for routine care.

Conclusion

Appropriate implementation of infection prevention and control measures and use of PPE remain a priority to protect health workers from SARS-CoV-2 infection.

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

医务工作者感染 SARS-CoV-2 的感染预防和控制风险因素：一项全球多中心病例对照研究。

背景：在 COVID-19 大流行期间，由于职业风险因素，医务工作者感染 SARS-CoV-2 的风险较高。作为世界卫生组织统一研究计划的一部分，我们旨在确定这些风险因素的特征：这项全球性、多中心、巢式病例对照研究在 21 个国家的 121 个医疗机构中进行。病例是指在入选前 14 天内，SARS-CoV-2 感染检测呈阳性并有记录表明曾与 COVID-19 患者有职业接触的医务工作者。对照组来自同一医疗机构，接触情况类似，但血清检测结果为阴性。病例和对照身份在基线和 3-4 周后通过血清学检测进行确认。采用结构化问卷收集人口统计学和感染风险因素数据：从 2020 年 6 月到 2021 年 12 月，共获得了 1213 例病例和 1844 例对照的数据。SARS-CoV-2感染风险与不遵守个人防护设备（PPE）指南（aOR 1-67 [95% CI 1-32-2-12]）和接触患者后未坚持进行手部卫生（aOR 2-52 [1-72-3-68]）有关。与 COVID-19 患者直接密切接触也与风险增加有关，尤其是在长时间接触（>15 分钟）时。在产生气溶胶的过程中使用呼吸器，在接触受污染的材料/表面时使用手套、防护服或工作服则与降低风险有关。在日常护理中使用呼吸器和外科口罩的医务人员之间没有发现差异：结论：适当实施感染预防和控制措施以及使用个人防护设备仍是保护医务工作者免受 SARS-CoV-2 感染的当务之急。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊

Journal of Hospital Infection 医学-传染病学

CiteScore

12.70

自引率

5.80%

发文量

271

审稿时长

19 days

期刊介绍： The Journal of Hospital Infection is the editorially independent scientific publication of the Healthcare Infection Society. The aim of the Journal is to publish high quality research and information relating to infection prevention and control that is relevant to an international audience. The Journal welcomes submissions that relate to all aspects of infection prevention and control in healthcare settings. This includes submissions that: provide new insight into the epidemiology, surveillance, or prevention and control of healthcare-associated infections and antimicrobial resistance in healthcare settings; provide new insight into cleaning, disinfection and decontamination; provide new insight into the design of healthcare premises; describe novel aspects of outbreaks of infection; throw light on techniques for effective antimicrobial stewardship; describe novel techniques (laboratory-based or point of care) for the detection of infection or antimicrobial resistance in the healthcare setting, particularly if these can be used to facilitate infection prevention and control; improve understanding of the motivations of safe healthcare behaviour, or describe techniques for achieving behavioural and cultural change; improve understanding of the use of IT systems in infection surveillance and prevention and control.