1. SARS-CoV-2 burden on the floor was associated with COVID-19 cases and outbreaks in two acute care hospitals: a prospective cohort study.
- Author
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Fralick M, Moggridge JA, Wiebe M, Castellani L, McGeer A, Feenstra B, Hinz A, Hicks AMA, Hug LA, Wong A, Van Bakel T, Abeygunawardena S, Burhunduli T, Mejbel HS, Kassen R, Thampi N, MacFadden D, and Nott C
- Abstract
Background: Recent work demonstrated that detection of SARS-CoV-2 on the floor of long-term care facilities is associated with impending COVID-19 outbreaks. It is unknown if similar results will be observed in hospitals., Methods: Floor swabs were prospectively collected weekly from healthcare worker-only areas (eg, staff locker rooms) at two hospitals in Ontario, Canada for 39 weeks. Floor swabs were processed for SARS-CoV-2 using quantitative reverse-transcriptase polymerase chain reaction. Results were reported as percentage of positive floor swabs and viral copy number. Grouped fivefold cross-validation was used to evaluate model outbreak discrimination., Results: SARS-CoV-2 RNA was detected on 537 of 760 floor swabs (71%). At Hospital A, overall positivity was 90% (95% CI: 85%-93%; N = 280); at Hospital B, overall positivity was 60% (95% CI: 55%-64%; N = 480). There were four COVID-19 outbreaks at Hospital A and seven at Hospital B during the study period. The outbreaks consisted of primarily patient cases (ie, 140 patient cases and 4 staff cases). For every 10-fold increase in viral copies, there was a 22-fold higher odds of a COVID-19 outbreak (OR = 22.0, 95% CI 7.3, 91.8). The cross-validated area under the receiver operating curve for SARS-CoV-2 viral copies for predicting a contemporaneous outbreak was 0.86 (95% CI 0.82-0.90)., Conclusion: Viral burden of SARS-CoV-2 on floors, even in healthcare worker-only areas, was strongly associated with COVID-19 outbreaks in those hospital wards. Built environment sampling may support hospital COVID-19 outbreak identification, fill gaps in traditional surveillance, and guide infection prevention and control measures.
- Published
- 2024
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