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. 2021 Apr:110:178-183.
doi: 10.1016/j.jhin.2021.02.005. Epub 2021 Feb 8.

Transmission of SARS-CoV-2 among healthcare workers and patients in a teaching hospital in the Netherlands confirmed by whole-genome sequencing

S Paltansing  1 , R S Sikkema  2 , S J de Man  3 , M P G Koopmans  2 , B B Oude Munnink  2 , P de Man  3
Affiliations

Transmission of SARS-CoV-2 among healthcare workers and patients in a teaching hospital in the Netherlands confirmed by whole-genome sequencing

S Paltansing et al. J Hosp Infect. 2021 Apr.

Abstract

Aim: To investigate the sources of infection among healthcare workers (HCWs) and patients in a teaching hospital in the Netherlands during the early stages of the coronavirus disease 2019 (COVID-19) pandemic using epidemiological and whole-genome sequencing data.

Methods: From 3rd April to 11th May 2020, 88 HCWs and 215 patients were diagnosed with COVID-19. Whole-genome sequences were obtained for 30 HCWs and 20 patients.

Results: Seven and 11 sequence types were identified in HCWs and patients, respectively. Cluster A was the most common sequence type, detected in 23 (77%) HCWs; of these, 14 (61%) had direct patient contact and nine (39%) had indirect patient contact. In addition, seven patients who were not hospitalized in the COVID-19 cohort isolation ward who became positive during their admission were infected with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) cluster A. Following universal masking of all HCWs and emphasis on physical distancing during meals and breaks, no further evidence was found for patient-to-HCW or HCW-to-HCW transmission or vice versa.

Conclusion: The finding that patients and HCWs were infected with SARS-CoV-2 cluster A suggests both HCW-to-HCW and HCW-to-patient transmission.

Keywords: COVID-19; Healthcare worker; Molecular typing; Outbreak; SARS-CoV-2; WGS.

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Figures

Figure 1
Figure 1
Timeline of 88 healthcare workers (HCWs) and 20 admitted patients with laboratory-confirmed severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) with their corresponding sequence cluster type. PCR, polymerase chain reaction; COVID-19, coronavirus disease 2019.
Figure 2
Figure 2
Maximum-likelihood phylogeny of all complete genomes of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) strains in the Netherlands (5th June 2020) and focusing on the SARS-CoV-2 strains described in this study. The scale indicates the number of nucleotide substitutions per site. Patient sequences are shown in blue and healthcare worker sequences are shown in red.
See this image and copyright information in PMC

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