Association of institutional masking policies with healthcare-associated SARS-CoV-2 infections in Swiss acute care hospitals during the BA.4/5 wave (CH-SUR study): a retrospective observational study.
Covid-19
Healthcare workers
Healthcare-associated infection
Masking policies
SARS-CoV-2
Journal
Antimicrobial resistance and infection control
ISSN: 2047-2994
Titre abrégé: Antimicrob Resist Infect Control
Pays: England
ID NLM: 101585411
Informations de publication
Date de publication:
18 Jun 2024
18 Jun 2024
Historique:
received:
06
02
2024
accepted:
05
06
2024
medline:
18
6
2024
pubmed:
18
6
2024
entrez:
17
6
2024
Statut:
epublish
Résumé
In the initial phase of the SARS-CoV-2 pandemic, masking has been widely accepted in healthcare institutions to mitigate the risk of healthcare-associated infection. Evidence, however, is still scant and the role of masks in preventing healthcare-associated SARS-CoV-2 acquisition remains unclear.We investigated the association of variation in institutional mask policies with healthcare-associated SARS-CoV-2 infections in acute care hospitals in Switzerland during the BA.4/5 2022 wave. SARS-CoV-2 infections in hospitalized patients between June 1 and September 5, 2022, were obtained from the "Hospital-based surveillance of COVID-19 in Switzerland"-database and classified as healthcare- or community-associated based on time of disease onset. Institutions provided information regarding institutional masking policies for healthcare workers and other prevention policies. The percentage of healthcare-associated SARS-CoV-2 infections was calculated per institution and per type of mask policy. The association of healthcare-associated SARS-CoV-2 infections with mask policies was tested using a negative binominal mixed-effect model. We included 2'980 SARS-CoV-2 infections from 13 institutions, 444 (15%) were classified as healthcare-associated. Between June 20 and June 30, 2022, six (46%) institutions switched to a more stringent mask policy. The percentage of healthcare-associated infections subsequently declined in institutions with policy switch but not in the others. In particular, the switch from situative masking (standard precautions) to general masking of HCW in contact with patients was followed by a strong reduction of healthcare-associated infections (rate ratio 0.39, 95% CI 0.30-0.49). In contrast, when compared across hospitals, the percentage of health-care associated infections was not related to mask policies. Our findings suggest switching to a more stringent mask policy may be beneficial during increases of healthcare-associated SARS-CoV-2 infections at an institutional level.
Sections du résumé
BACKGROUND
BACKGROUND
In the initial phase of the SARS-CoV-2 pandemic, masking has been widely accepted in healthcare institutions to mitigate the risk of healthcare-associated infection. Evidence, however, is still scant and the role of masks in preventing healthcare-associated SARS-CoV-2 acquisition remains unclear.We investigated the association of variation in institutional mask policies with healthcare-associated SARS-CoV-2 infections in acute care hospitals in Switzerland during the BA.4/5 2022 wave.
METHODS
METHODS
SARS-CoV-2 infections in hospitalized patients between June 1 and September 5, 2022, were obtained from the "Hospital-based surveillance of COVID-19 in Switzerland"-database and classified as healthcare- or community-associated based on time of disease onset. Institutions provided information regarding institutional masking policies for healthcare workers and other prevention policies. The percentage of healthcare-associated SARS-CoV-2 infections was calculated per institution and per type of mask policy. The association of healthcare-associated SARS-CoV-2 infections with mask policies was tested using a negative binominal mixed-effect model.
RESULTS
RESULTS
We included 2'980 SARS-CoV-2 infections from 13 institutions, 444 (15%) were classified as healthcare-associated. Between June 20 and June 30, 2022, six (46%) institutions switched to a more stringent mask policy. The percentage of healthcare-associated infections subsequently declined in institutions with policy switch but not in the others. In particular, the switch from situative masking (standard precautions) to general masking of HCW in contact with patients was followed by a strong reduction of healthcare-associated infections (rate ratio 0.39, 95% CI 0.30-0.49). In contrast, when compared across hospitals, the percentage of health-care associated infections was not related to mask policies.
CONCLUSIONS
CONCLUSIONS
Our findings suggest switching to a more stringent mask policy may be beneficial during increases of healthcare-associated SARS-CoV-2 infections at an institutional level.
Identifiants
pubmed: 38886813
doi: 10.1186/s13756-024-01422-4
pii: 10.1186/s13756-024-01422-4
doi:
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
64Subventions
Organisme : Schweizerische Akademie der Medizinischen Wissenschaften
ID : YTCR 12/22
Informations de copyright
© 2024. The Author(s).
Références
Infect Control Hosp Epidemiol. 2022 Jun;43(6):757-763
pubmed: 33934743
Clin Invest Med. 2021 Jun 14;44(2):E48-54
pubmed: 34152707
N Engl J Med. 2023 Jul 6;389(1):4-6
pubmed: 37314330
J Health Econ. 2022 Mar;82:102592
pubmed: 35104669
Zhonghua Liu Xing Bing Xue Za Zhi. 2004 Jan;25(1):18-22
pubmed: 15061941
Infect Dis Poverty. 2020 Jul 23;9(1):104
pubmed: 32703281
Am J Dis Child. 1981 Jun;135(6):512-5
pubmed: 7234784
Clin Infect Dis. 2021 Nov 2;73(9):1693-1695
pubmed: 33704451
J Infect Dev Ctries. 2020 Nov 30;14(11):1231-1237
pubmed: 33296333
Lancet. 2003 May 3;361(9368):1519-20
pubmed: 12737864
Infect Control Hosp Epidemiol. 2020 Dec;41(12):1466-1467
pubmed: 32576336
Ann Intern Med. 2020 Oct 6;173(7):542-555
pubmed: 32579379
Occup Med (Lond). 2020 Dec 12;70(8):606-609
pubmed: 33225363
Ann Intern Med. 2023 Jun;176(6):859-861
pubmed: 37068281
Influenza Other Respir Viruses. 2016 Jul;10(4):268-90
pubmed: 26901358
Psychiatry Res. 2021 Aug;302:114036
pubmed: 34098157
Influenza Other Respir Viruses. 2017 Nov;11(6):511-517
pubmed: 28799710
Elife. 2020 May 11;9:
pubmed: 32392129
J Hosp Infect. 2022 Feb;120:81-84
pubmed: 34861313
PLoS Med. 2021 Oct 12;18(10):e1003816
pubmed: 34637439
Swiss Med Wkly. 2021 Feb 15;151:w20475
pubmed: 33638351
BMC Pulm Med. 2019 Oct 30;19(1):190
pubmed: 31666061
JAMA. 2020 Aug 18;324(7):703-704
pubmed: 32663246
J Hosp Infect. 2023 Apr;134:108-120
pubmed: 36738991
J Occup Environ Med. 2021 Jun 1;63(6):476-481
pubmed: 33596025
J Hosp Infect. 2022 Mar;121:82-90
pubmed: 34929232
JAMA Netw Open. 2022 Aug 1;5(8):e2226816
pubmed: 35969403