Seroprevalence of Covid-19 infection among healthcare workers: A study from a tertiary care hospital in the National Capital Region of India

BACKGROUND Seroprevalence studies on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can provide information on the target populations for vaccination. We aimed to evaluate the seroprevalence among healthcare workers (HCWs) at our tertiary care institution and to identify parameters that may affect it. METHOD We assessed seroprevalence of SARS-CoV-2 by the chemiluminescence immunoassay test among 3258 HCW in our hospital and evaluated as per gender, age, their previous Covid-19 diagnosis, role in hospital and type/risk of exposure. RESULTS Of 3258 participants, 46.2% (95% CI 44.4%– 47.9%) were positive for SARS-CoV-2 IgG antibodies (i.e. IgG ?15 AU/ml). Higher seroprevalence was seen in non-clinical HCWs (50.2%) than in clinical HCWs (41.4%, p=0.0001). Furthermore, people with a history of Covid-19 were found to have significantly higher antibody levels (p=0.0001). Among the HCWs, doctors and nurses had lower relative risk (RR) of acquiring Covid-19 infection (RR=0.82; 95% CI 0.76–0.89) compared to non-clinical HCWs. CONCLUSION Seroprevalence in HCWs at our hospital was 46.2%. Clinical HCWs had lower seroprevalence compared to non-clinical HCWs. Previous history of Covid-19 almost doubled the seropositivity, particularly in those with current infection.

Safety, immunogenicity & effectiveness of the COVID-19 vaccine among healthcare workers in a tertiary care hospital

Background & objectives: The COVID-19 pandemic has caused significant global morbidity and mortality. As the vaccination was rolled out with prioritization on healthcare workers (HCWs), it was desirable to generate evidence on effectiveness of vaccine in prevailing real-life situation for policy planning. The objective of the study was to evaluate the safety, effectiveness and immunogenicity of COVID-19 vaccination among HCWs in a tertiary care hospital. Methods: This prospective observational study was undertaken on the safety, immunogenicity and effectiveness of the ChAdOx1 nCoV- 19 coronavirus vaccine (Recombinant) during the national vaccine roll out in January-March 2021, in a tertiary care hospital, New Delhi, India. Results: The vaccine was found to be safe, with local pain, fever and headache as the most common adverse events of milder nature which generally lasted for two days. The adverse events following vaccination were lower in the second dose as compared to the first dose. The vaccine was immunogenic, with seropositivity, which was 51 per cent before vaccination, increasing to 77 per cent after single dose and 98 per cent after two doses. Subgroup analysis indicated that those with the past history of COVID-19 attained seropositivity of 98 per cent even with single dose. The incidence of reverse transcription (RT)-PCR positive COVID-19 was significantly lower among vaccinated (11.7%) as compared to unvaccinated (22.2%). Seven cases of moderate COVID-19 needing hospitalization were seen in the unvaccinated and only one such in the vaccinated group. The difference was significant between the fully vaccinated (10.8%) and the partially vaccinated (12.7%). The hazard of COVID-19 infection was higher among male, age >50 yr and clinical role in the hospital. After adjustment for these factors, the hazard of COVID-19 infection among unvaccinated was 2.09 as compared to fully vaccinated. Vaccine effectiveness was 52.2 per cent in HCWs. Interpretation & conclusions: ChAdOx1 nCoV-19 coronavirus vaccine (Recombinant) was safe, immunogenic as well as showed effectiveness against the COVID-19 disease (CTRI/2021/01/030582).

In vitro evaluation of a new cefixime-clavulanic acid combination for gram-negative bacteria.

The study was conducted to evaluate a new cefixime-clavulanic acid combination for in vitro susceptibility towards gram-negative bacteria. A total of 220 isolates of Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeroginosa, Acinetobacter spp, Salmonella enterica serovar Typhi and Salmonella enterica serovar Typhimurium were included in the study. The isolates were tested for susceptibility towards the new combination antimicrobial molecule cefixime with clavulanic acid by disk diffusion and Epsilometer strip (E-strip) Minimum Inhibitary Concentration (MIC) method. Of the 101 E. coli and K. pneumoniae isolates, 62.4% were found to be extended spectrum beta-lactamase (ESBL) producers. Almost half of these were from the community and 55.6% were hospital isolates. Of the ESBL isolates, 19% were AmpC (cephalosporinases that are poorly inhibited by beta lactamase inhibitor) producers while the remaining 81% were non AmpC ESBL producers. The AmpC producers were resistant to both cefixime and the combination, while the non-AmpC producers were sensitive to the combination. The addition of clavulanate to cefixime did not improve the sensitivities of P. aeruginosa and Acinetobacter isolates. There were no ESBL isolates among the S. Typhi isolates, all of which were sensitive to cefixime. Of the S. Typhimurium, 88.9% were ESBL producers and all of these were resistant to cefixime but sensitive to the combination. The combination of cefixime with clavulanic acid offers the advantage of oral administration and appears to be a viable option for the treatment of uncomplicated community acquired infections caused by non-AmpC ESBL producing gram-negative bacteria.

Prevalence of HIV-associated cryptococcal meningitis and utility of microbiological determinants for its diagnosis in a tertiary care center.

CONTEXT: Human immunodeficiency virus (HIV) infection continues to be the most important risk factor for the development of central nervous system (CNS) cryptococcosis, which in turn is an important contributor to morbidity and mortality in HIV-infected patients. Early diagnosis of such patients is the key to their therapeutic success. AIMS: This study was undertaken to find out the prevalence of CNS cryptococcosis and to assess the role of microbiological parameters for its specific diagnosis in HIV-reactive hospitalized patients admitted with meningeal signs in a tertiary care setting. MATERIALS AND METHODS: A total of 104 patients suspected to be suffering from meningitis/meningoencephalitis were subjected to cerebrospinal fluid (CSF) analysis (including India ink preparation, culture by conventional methods and Bactec MGIT 960 system, antigen detection) and tests for HIV antibodies by standard laboratory operating procedures. RESULTS: The prevalence of HIV infection in our study group was 12.5% (13/104), while the prevalence of cryptococcal CNS infection in HIV-reactive cohort was 46% (6/13). Additionally, 15.3% (2/13) of the patients from this cohort were positive for Mycobacterium tuberculosis. CONCLUSIONS: High prevalence of cryptococcal CNS infections in HIV-infected patients underscores the importance of precise and early microbiological diagnosis for better management of such patients.