Infection prevention; SARS-CoV-2; COVID-19; Healthcare-associated infection; Outbreaks; Healthcare workers
Lenggenhager Lauriane, Martischang Romain, Sauser Julien, Perez Monica, Vieux Laure, Graf Christophe, Cordey Samuel, Laubscher Florian, Nunes Tomás Robalo, Zingg Walter, Cori Anne, Harbarth Stephan, Abbas Mohamed (2022), Occupational and community risk of SARS-CoV-2 infection among employees of a long-term care facility: an observational study, in Antimicrobial Resistance & Infection Control
, 11(1), 51-51.
Robalo Nunes Tomás, Lebowitz Dan, Fraccaro Marlène, Perez Monique, Vieux Laure, Abbas Mohamed, Graf Christophe, Harbarth Stephan (2022), Can long-term care facilities remain a coronavirus disease 2019 (COVID-19)–free bubble? An outbreak report, in Infection Control & Hospital Epidemiology
, 43(3), 410-411.
AbbasMohamed, CoriAnne, CordeySamuel, LaubscherFlorian, Robalo NunesTomás, MyallAshleigh, SalamunJulien, HuberPhilippe, ZekryDina, PrendkiVirginie, ItenAnne, VieuxLaure, SauvanValérie, GrafChristophe, HarbarthStephan (2022), Reconstructing transmission chains of SARS-CoV-2 amid multiple outbreaks in a geriatric acute-care hospital, 2022.01.07.
Abbas Mohamed, Robalo Nunes Tomás, Martischang Romain, Zingg Walter, Iten Anne, Pittet Didier, Harbarth Stephan (2021), Nosocomial transmission and outbreaks of coronavirus disease 2019: the need to protect both patients and healthcare workers, in Antimicrobial Resistance & Infection Control
, 10(1), 7-7.
Vuichard-Gysin Danielle, Abbas Mohamed, Harbarth Stephan (2021), In-hospital COVID-19 outbreak investigation: A practical approach to root cause analysis, in Intensive and Critical Care Nursing
, 67, 103132-103132.
Suppan Melanie, Stuby Loric, Harbarth Stephan, Fehlmann Christophe A, Achab Sophia, Abbas Mohamed, Suppan Laurent (2021), Nationwide Deployment of a Serious Game Designed to Improve COVID-19 Infection Prevention Practices in Switzerland: Prospective Web-Based Study, in JMIR Serious Games
, 9(4), e33003-e33003.
Abbas Mohamed, Nunes Tomás Robalo, Cori Anne, Cordey Samuel, Laubscher Florian, Baggio Stephanie, Jombart Thibaut, Iten Anne, Vieux Laure, Teixeira Daniel, Perez Monica, Pittet Didier, Frangos Emilia, Graf Christophe E., Zingg Walter, Harbarth Stephan (2021), Explosive nosocomial outbreak of SARS-CoV-2 in a rehabilitation clinic: the limits of genomics for outbreak reconstruction, in Journal of Hospital Infection
Suppan Mélanie, Abbas Mohamed, Catho Gaud, Stuby Loric, Regard Simon, Achab Sophia, Harbarth Stephan, Suppan Laurent (2021), Impact of a Serious Game (Escape COVID-19) on the Intention to Change COVID-19 Control Practices Among Employees of Long-term Care Facilities: Web-Based Randomized Controlled Trial, in Journal of Medical Internet Research
, 23(3), e27443-e27443.
Suppan Laurent, Abbas Mohamed, Catho Gaud, Stuby Loric, Regard Simon, Harbarth Stephan, Achab Sophia, Suppan Mélanie (2020), Impact of a Serious Game on the Intention to Change Infection Prevention and Control Practices in Nursing Homes During the COVID-19 Pandemic: Protocol for a Web-Based Randomized Controlled Trial, in JMIR Research Protocols
, 9(12), e25595-e25595.
Suppan Laurent, Stuby Loric, Gartner Birgit, Larribau Robert, Iten Anne, Abbas Mohamed, Harbarth Stephan, Suppan Mélanie (2020), Impact of an e-learning module on personal protective equipment knowledge in student paramedics: a randomized controlled trial, in Antimicrobial Resistance & Infection Control
, 9(1), 185-185.
Suppan Mélanie, Catho Gaud, Robalo Nunes Tomás, Sauvan Valérie, Perez Monique, Graf Christophe, Pittet Didier, Harbarth Stephan, Abbas Mohamed, Suppan Laurent (2020), A Serious Game Designed to Promote Safe Behaviors Among Health Care Workers During the COVID-19 Pandemic: Development of “Escape COVID-19”, in JMIR Serious Games
, 8(4), e24986-e24986.
Suppan Laurent, Abbas Mohamed, Stuby Loric, Cottet Philippe, Larribau Robert, Golay Eric, Iten Anne, Harbarth Stephan, Gartner Birgit, Suppan Mélanie (2020), Effect of an E-Learning Module on Personal Protective Equipment Proficiency Among Prehospital Personnel: Web-Based Randomized Controlled Trial, in Journal of Medical Internet Research
, 22(8), e21265-e21265.
Suppan Mélanie, Gartner Birgit, Golay Eric, Stuby Loric, White Marion, Cottet Philippe, Abbas Mohamed, Iten Anne, Harbarth Stephan, Suppan Laurent (2020), Teaching Adequate Prehospital Use of Personal Protective Equipment During the COVID-19 Pandemic: Development of a Gamified e-Learning Module, in JMIR Serious Games
, 8(2), e20173-e20173.
Background and rationaleDuring the Coronavirus disease 2019 (COVID-19) pandemic, 3 nosocomial outbreaks occurred in distinct sites in the Department of Rehabilitation and Geriatrics of Geneva University Hospitals. After enhancing infection prevention and control, the outbreaks were successfully controlled. Protection of healthcare workers (HCWs) is a key priority whilst caring for severe acute respiratory syndrome (SARS-CoV-2) infected patients. Similarly, preventing healthcare-associated COVID-19 among COVID-19 negative patients is key. Particular attention should be placed on vulnerable patients in long-term care facilities and geriatrics. In the outbreaks we describe, the complex interplay between and respective role of HCWs and patients in transmission remains unclear. Aim and objectives The overarching objective of this study is to reconstruct the outbreaks in each hospital site (A, B, C) combining epidemiological with genetic data, in order to understand transmission dynamics and improve infection control practices and consider additional preventive strategies.Specific aimsSpecific aims of the study include:•Compute the attack rate in the institution among patients and HCWs•Establish viral transmission pathways of the outbreak and reconstructing a transmission tree•Identify the directionality of transmission (i.e. HCW to HCW, HCW to patient, patient to HCW, community to HCW)•Identify risk factors for healthcare-associated SARS-CoV-2 infection and mortality among patients •Identify risk factors for HCW SARS-CoV-2 infection •Describe and analyse variation among infection control practices across the 3 sites•Identify and develop new strategies to prevent healthcare-associated COVID infection Study design and expected resultsThis is a retrospective cohort study of COVID-19 clusters involving 104 patients and 185 HCWs in 3 distinct hospital sites of the Geneva University Hospitals. We will obtain clinical and epidemiological data of all SARS-CoV-2 positive patients and HCWs. We will construct epidemic curves by ward for patients and HCWs, and compute attack rates and doubling times. These data will help to construct a putative transmission tree. We will perform a nested case-control study in one of the sites that will seek to establish risk factors of HCW infection by SARS-CoV-2. Exposure to COVID-19 patients and other HCWs is assessed, as well as potential community exposure. A nested case-control study will be performed in order to identify risk factors for healthcare-associated SARS-CoV-2 infection among patients, and a case-case-control study to identify risk factors for mortality among these patients.SARS-CoV-2 complete genome sequences will be generated using an amplicon-based next generation sequencing protocol. Complete viral genomes will be obtained after mapping reads to a SARS-CoV-2 reference sequence. We will combine epidemiologic and genetic data using the “outbreaker” package in R software. We will use a Bayesian framework, which will combine the distribution of the generation time, from which a probabilistic transmission tree is constructed, as well as a model of sequence evolution along the transmission chain. We will impute generation times from estimates available from the literature. The output from the model will allow us to estimate the dates of infection, mutation rates, multiple importation events, missed cases, as well as to reconstruct the transmission tree. Expected impactAnalysis of these nosocomial outbreaks will provide key insights into transmission dynamics of SARS-CoV-2 in the healthcare setting and will inform infection prevention guidelines in order to enhance protection of HCWs and patients. Furthermore, this study will demonstrate the added value of genome sequencing in elucidating the complex connectivity of SARS-CoV-2 dissemination in hospitals.