The effectiveness of mRNA vaccines to prevent SARS-CoV-2 infection and hospitalisation for COVID-19 according to the time elapsed since their administration in health professionals in the Valencian Autonomous Community (Spain).

The objective was to understand the effectiveness of the BNT162b2 and mRNA-1273 vaccines against SARS-CoV-2 in health professionals(HPs) in the Valencian Autonomous Community(Spain) who had completed a full vaccination regimen, both in terms of preventing infections and avoiding hospitalisations, according to the time elapsed since the vaccine administration. Case-controlled study with negative test results. HPs who had undergone at least one PCR or antigen(Ag) active infection diagnostic test(AIDT) to rule out SARS-CoV-2 infection between 25 January and 18 July 2021 were included. HPs with positive AIDT result were considered as cases and those with a negative result controls. Adjusted vaccine effectiveness(VEa) to prevent SARS-CoV-2 infection and its 95% confidence interval(95% CI) were calculated using the formula VEa = (1 - OR) × 100. The VEa for the prevention of SARS-CoV-2 infection 12 to 120 days after completing the full two-dose vaccine regimen was 91.6%(95%CI[89.6%,93.2%]) for the BNT162b2 vaccine and 95.2%(95%CI[88.3%,98.1%]) for the mRNA-1273 vaccine. After 120 days the VEa was 71.5%(95%CI[67.0%,75.5%]) for the BNT162b2 vaccine and 88.3%(95%CI[75.7,94.4%]) for the mRNA-1273 vaccine. The VEa for prevention of hospitalisation for COVID-19 for the complete two-dose regimen of mRNA vaccines (BNT162b2 and mRNA-1273) was 96.8%(95%CI[76.1%,99.6%]). The administration of the complete regimen of the BNT162b2 and mRNA-1273 vaccine against SARS-CoV-2 was highly effective for the prevention of COVID-19 cases in HPs when 12 to 120 days had elapsed since the second dose. However, said effectiveness decreased as time from the vaccine administration elapsed, although it was maintained for the prevention of hospitalisation of HPs.

Efectividad de la vacuna BNT162b2 para prevenir la COVID-19 en personal sanitario / Effectiveness of BNT162b2 vaccine to preventing COVID-19 in healthcare personnel

Objetivo: Conocer la efectividad de la vacuna BNT162b2 en personal sanitario de un departamento de salud. Método: Estudio de casos y controles con prueba negativa. Se incluyó personal sanitario con sospecha de COVID-19 y personal sanitario que fue contacto estrecho de casos de COVID-19 entre el 25 de enero y el 6 de junio de 2021. Se les realizó prueba de reacción en cadena de la polimerasa (PCR) para SARS-CoV-2; aquellos con PCR positiva fueron considerados casos y aquellos con PCR negativa fueron considerados controles. Se calculó la efectividad vacunal ajustada (EVa) para prevenir casos de COVID-19 y su intervalo de confianza del 95% (IC95%), mediante la fórmula EV = (1 − odds ratio) × 100. Resultados: Se incluyeron 624 profesionales sanitarios; de ellos, 43 (6,9%) casos y 581 (93,1%) controles. La EVa de la pauta completa fue del 96,3% (IC95%: 82,5-99,2) y la de la pauta incompleta del 68,0% (IC95%: 30,0-85,4). Conclusiones: La administración de la pauta completa de vacuna es efectiva para la prevención de casos de COVID-19 en el personal sanitario. (AU)

Objective: To assess the effectiveness of the vaccine against SARS-CoV-2 (BNT162b2) in healthcare personnel of a health department. Method: Test-negative case̶control study. Healthcare personnel with suspected COVID-19 and healthcare personnel close contacts of COVID-19 cases were included between January 27th and June 6 th, 2021. They were PCR tested for SARS-CoV-2; those with positive PCR were considered cases and those with negative PCR were considered controls. The adjusted vaccine effectiveness (aVE) to prevent COVID-19 cases and their 95% confidence interval (95%CI) were calculated using the formula VE = (1 − odds ratio) × 100. Results: 624 healthcare personnel were included, of which 43 (6.9%) were considered cases and 581 (93.8%) controls. The aVE of the complete regimen was 96.3% (95%CI: 82.5̶99.2). The aVE of the incomplete pattern was 68.0% (95%CI: 30.0̶85.4). Conclusions: The administration of the complete pattern of BNT162b2 vaccine against SARS-CoV-2 is effective for the prevention of cases of COVID-19 in healthcare personnel. (AU)

Effectiveness of the systematic use of antimicrobial filters in the water taps of critical care units for the prevention of healthcare-associated infections with Pseudomonas aeruginosa.

BACKGROUND: Pseudomonas aeruginosa (PA) is the third leading aetiological agent in healthcare-associated infections (HAIs) and the one most frequently found in patients with pneumonia associated with mechanical ventilation. In intensive care units (ICU), its appearance is associated with higher mortality, an increase in the days spent on ventilation, and hospital stay length and costs. Thus, evaluating strategies for preventing these infections is essential for their control. Therefore, our objective was to evaluate the effectiveness of the systematic use of antimicrobial filters in preventing PA infections in critical care units. METHODS: This was an open experimental crossover study. A total of 2,156 patients admitted for more than 24 hours in critical care units were included, 1,129 of them in units with filters, and 1,027 in units without filters. The study groups were followed-up for 24 months and HAIs were checked for the presence of PA. Chi-squared test were used to compare the rate of HAIs between groups and we calculated 95% confidence intervals adjusted by Poisson regression for the rate ratio (RR) of the association magnitude. RESULTS: Both groups were homogeneous in terms of intrinsic and extrinsic patient factors. The incidence of PA infections in the units with filters was 5.5 cases/1,000 hospitalized days and 5.4/1,000 hospitalized days for the units without water filters (RR = 1.09 [0.67-1.79]). CONCLUSIONS: Routine placing antimicrobial filters in the water taps in critical care units was not an effective means of preventing the emergence of HAIs caused by PA.

Estimated Costs Associated with Surgical Site Infections in Patients Undergoing Cholecystectomy.

Among healthcare-associated infections, surgical site infections (SSIs) are the most frequent in Spain. The aim of this work was to estimate the costs of SSIs in patients who underwent a cholecystectomy at the Hospital General Universitario de Alicante (Spain) between 2012-2017. This was a prospective observational cohort study. The Active Epidemiological Surveillance Program at our hospital recorded all the cholecystectomies performed. Risk factors associated with the development of SSIs were determined by multivariate analysis and two homogeneous comparison groups were obtained by using the propensity score. The number of extra days of hospital stay were recorded for patients with an SSI and with the cost per hospitalised day data, the additional cost attributed to SSIs was calculated. A total of 2200 cholecystectomies were considered; 110 patients (5.0%) developed an SSI. The average length of hospital stay was 5.6 days longer among patients with an SSI. The cost per SSI was EUR 1890.60 per patient, with the total cost for this period being EUR 207,961.60. SSIs after cholecystectomy lead to a prolongation of hospital stay and an increase in economic costs. It is essential to implement infection surveillance and control programs to reduce SSIs, improve patient safety, and reduce economic burden.

[Effectiveness of BNT162b2 vaccine to preventing COVID-19 in healthcare personnel]. / Efectividad de la vacuna BNT162b2 para prevenir la COVID-19 en personal sanitario.

OBJECTIVE: To assess the effectiveness of the vaccine against SARS-CoV-2 (BNT162b2) in healthcare personnel of a health department. METHOD: Test-negative case̶control study. Healthcare personnel with suspected COVID-19 and healthcare personnel close contacts of COVID-19 cases were included between January 27th and June 6th, 2021. They were PCR tested for SARS-CoV-2; those with positive PCR were considered cases and those with negative PCR were considered controls. The adjusted vaccine effectiveness (aVE) to prevent COVID-19 cases and their 95% confidence interval (95%CI) were calculated using the formula VE=(1-odds ratio)×100. RESULTS: 624 healthcare personnel were included, of which 43 (6.9%) were considered cases and 581 (93.8%) controls. The aVE of the complete regimen was 96.3% (95%CI: 82.5̶99.2). The aVE of the incomplete pattern was 68.0% (95%CI: 30.0̶85.4). CONCLUSIONS: The administration of the complete pattern of BNT162b2 vaccine against SARS-CoV-2 is effective for the prevention of cases of COVID-19 in healthcare personnel.

[Sero-epidemiological study of SARS-CoV-2 infection among healthcare personnel in a healthcare department]. / Estudio de sero-epidemiología de la infección por SARS-CoV-2 en profesionales sanitarios de un departamento sanitario.

OBJECTIVE: Estimate IgG antibody prevalence against SARS-CoV-2 in healthcare personnel (HCP) of a healthcare department (HD). METHOD: Prevalence study. The presence of IgG antibodies against SARS-CoV-2 was determined in HCP of the HD. Enzyme linked immunosorbent assays (ELISA) tests were used. Field work took place from April 24, 2020 to May 8, 2020. The age, sex, occupation (physician, nurse, etc.) and the work area (Primary Care, Emergency Room, etc.) were gathered. The IgG antibody prevalence was then calculated with its 95% confidence interval (95% CI). To study the association between HCP characteristics and the presence IgG the Chi Square test was used, and to study the magnitude of association, the Odds Ratio (95% CI) was calculated. RESULTS: Of the 4813 HCP in the HD, 4179 (87,1%) participated. Of these, 73,3% (3065) were women and 26,7% (1114) men. The global prevalence of IgG antibodies against SARS-CoV-2 was 6,6% (95% CI: 5,8-7,3). There were statistically significant differences depending on the occupation, from 8,7% (95% CI: 6,9-10,6) on medics down to 3,2% (95% CI: 1,0-8,0) on personnel not associated with health care. The other characteristics did not associate significantly to antibody presence against SARS-CoV-2. CONCLUSION: The SARS-CoV-2 infection frequency in HCP is similar to the estimated in the general population for big cities in Spain. This highlights the effectiveness of the infection control and prevention programme in this healthcare department targeted at healthcare personnel.

Sero-epidemiological study of SARS-CoV-2 infection among healthcare personnel in a healthcare department.

OBJECTIVE: Estimate IgG antibody prevalence against SARS-CoV-2 in healthcare personnel (HCP) of a healthcare department (HD). METHOD: Prevalence study. The presence of IgG antibodies against SARS-CoV-2 was determined in HCP of the HD. Enzyme linked immunosorbent assays (ELISA) tests were used. Field work took place from April 24, 2020 to May 8, 2020. The age, sex, occupation (physician, nurse, etc.) and the work area (Primary Care, Emergency Room, etc.) were gathered. The IgG antibody prevalence was then calculated with its 95% confidence interval (95% CI). To study the association between HCP characteristics and the presence IgG the Chi Square test was used, and to study the magnitude of association, the Odds Ratio (95% CI) was calculated. RESULTS: Of the 4813 HCP in the HD, 4179 (87,1%) participated. Of these, 73,3% (3065) were women and 26,7% (1114) men. The global prevalence of IgG antibodies against SARS-CoV-2 was 6,6% (95% CI: 5,8-7,3). There were statistically significant differences depending on the occupation, from 8,7% (95% CI: 6,9-10,6) on medics down to 3,2% (95% CI: 1,0-8,0) on personnel not associated with health care. The other characteristics did not associate significantly to antibody presence against SARS-CoV-2. CONCLUSION: The SARS-CoV-2 infection frequency in HCP is similar to the estimated in the general population for big cities in Spain. This highlights the effectiveness of the infection control and prevention programme in this healthcare department targeted at healthcare personnel.

Estudio de sero-epidemiología de la infección por SARS-CoV-2 en profesionales sanitarios de un departamento sanitario / Sero-epidemiological study of SARS-CoV-2 infection among healthcare personnel in a healthcare department

Objetivo: Estimar la prevalencia de anticuerpos IgG frente a SARS-CoV-2 en profesionales sanitarios (PS) de un departamento sanitario (DS). Métodos: Estudio de prevalencia. Se determinó la presencia de anticuerpos IgG frente a SARS-CoV-2 en los PS del DS. La determinación se realizó mediante la técnica de ELISA. El trabajo de campo se realizó del 24 de abril de 2020 al 8 de mayo de 2020. Se recogieron edad, sexo, estamento (facultativo, enfermería, etc.) y área de trabajo (atención primaria, urgencias, etc.). Se calculó la prevalencia de anticuerpos IgG frente a SARS-CoV-2 con su intervalo de confianza al 95% (IC95%). Para estudiar la asociación entre las características de los PS y la presencia de IgG se utilizó la prueba de la ji cuadrado y para cuantificar la magnitud de asociación se calculó la odds ratio (IC95%). Resultados: De los 4.813 PS del DS participaron 4.179 (87,1%). De estos, el 73,3% (3.065) eran mujeres y el 26,7% (1.114) hombres. La prevalencia global de presencia de anticuerpos IgG frente a SARS-CoV-2 fue del 6,6% (IC95%: 5,8-7,3). Hubo diferencias estadísticamente significativas según estamento, oscilando del 8,7% (IC95%: 6,9-10,6) en facultativos al 3,2% (IC95%: 1,0-8,0) en otro personal no sanitario. El resto de características no se asociaron de forma significativa a la presencia de anticuerpos frente a SARS-CoV-2. Conclusión: La frecuencia de infección por SARS-CoV-2 en PS es similar a la estimada para la población general en grandes ciudades en España, lo que orienta sobre la efectividad del programa de prevención y control de infecciones dirigido a los profesionales sanitarios en este DS.(AU)

Objective: Estimate IgG antibody prevalence against SARS-CoV-2 in healthcare personnel (HCP) of a healthcare department (HD). Method: Prevalence study. The presence of IgG antibodies against SARS-CoV-2 was determined in HCP of the HD. Enzyme linked immunosorbent assays (ELISA) tests were used. Field work took place from April 24, 2020 to May 8, 2020. The age, sex, occupation (physician, nurse, etc.) and the work area (Primary Care, Emergency Room, etc.) were gathered. The IgG antibody prevalence was then calculated with its 95% confidence interval (95%CI). To study the association between HCP characteristics and the presence IgG the Chi Square test was used, and to study the magnitude of association, the Odds Ratio (95%CI) was calculated. Results: Of the 4813 HCP in the HD, 4179 (87,1%) participated. Of these, 73,3% (3065) were women and 26,7% (1114) men. The global prevalence of IgG antibodies against SARS-CoV-2 was 6,6% (95%CI: 5,8-7,3). There were statistically significant differences depending on the occupation, from 8,7% (95%CI: 6,9-10,6) on medics down to 3,2% (95%CI: 1,0-8,0) on personnel not associated with health care. The other characteristics did not associate significantly to antibody presence against SARS-CoV-2. Conclusion: The SARS-CoV-2 infection frequency in HCP is similar to the estimated in the general population for big cities in Spain. This highlights the effectiveness of the infection control and prevention programme in this healthcare department targeted at healthcare personnel.(AU)

Efectividad de la vacuna de la gripe para prevenir casos graves. Temporada 2018/2019 / Effectiveness of flu vaccine in the prevention of severe cases. Season 2018-2019

Objetivo: Conocer la efectividad de la vacuna de la gripe de la temporada 2018/2019 para la prevención de casos graves de gripe en un hospital terciario. Método: Estudio de casos y controles. Se incluyeron todos los pacientes hospitalizados con gripe confirmada por laboratorio durante la temporada 2018/2019. Los que cumplieron criterios de caso grave de gripe (neumonía, fallo multiorgánico, shock séptico, ingreso en la unidad de cuidados intensivos o muerte) se consideraron caso. Los que no cumplían criterios de gravedad se consideraron controles. Se calculó la efectividad de la vacuna (EV) cruda y ajustada (para prevenir casos graves de gripe), así como su intervalo de confianza del 95%, mediante la fórmula EV = (1 − odds ratio) × 100. Resultados: La efectividad ajustada por grupo de edad y comorbilidad fue del 60,7% (20,5-80,5). En el análisis ajustado y restringido a cada sexo, grupo de edad y presencia de comorbilidad, la vacuna de la gripe tuvo un efecto positivo en todos los grupos y categorías, siendo la efectividad del 55,0% (2,6-79,2) en el grupo de edad de 65 años o más. Conclusiones: La vacunación antigripal redujo la gravedad de la gripe en los pacientes hospitalizados. Estos hallazgos deberían tenerse en cuenta para mejorar las estrategias de vacunación y alcanzar mejores coberturas vacunales en la población de riesgo, con la finalidad no solo de disminuir los casos de gripe, sino también su gravedad. (AU)

Objective: To know the effectiveness of the 2018/2019 flu vaccine for the prevention of severe cases of flu in a tertiary hospital. Method: Case-control study. We included all patients hospitalized with influenza confirmed by laboratory during 2018/2019 season. Those who met the criteria of severe case of influenza (pneumonia, multiorgan failure, septic shock, ICU admission or death) were considered as cases. Non severe cases of influenza were included in the control group. We calculated the effectiveness of the raw and adjusted vaccine (to prevent severe cases of influenza) and its 95% confidence interval using formula VE = (1 − odds ratio) × 100. Results: Effectiveness of flu vaccine adjusted by age group and comorbidities was 60.7% (20.5-80.5). In the analysis adjusted and restricted to each sex, age group and presence of comorbidities, the influenza vaccine had a positive effect in all groups and categories, with effectiveness in the age group 65 years or more being 55.0% (2.6-79.2). Conclusions: Flu vaccination reduced the severity of influenza in hospitalized patients. These findings should be taken into account to improve vaccination strategies and achieve better vaccination coverage in the high-risk population in order not only to decrease flu cases, but also their severity. (AU)

Effectivity of a Program for the Control and Prevention of COVID-19 Healthcare-Associated Infections in a Spanish Academic Hospital.

BACKGROUND: Although recommendations to prevent COVID-19 healthcare-associated infections (HAIs) have been proposed, data on their effectivity are currently limited. OBJECTIVE: The aim was to evaluate the effectivity of a program of control and prevention of COVID-19 in an academic general hospital in Spain. METHODS: We captured the number of COVID-19 cases and the type of contact that occurred in hospitalized patients and healthcare personnel (HCP). To evaluate the impact of the continuous use of a surgical mask among HCP, the number of patients with COVID-19 HAIs and accumulated incidence of HCP with COVID-19 was compared between the preintervention and intervention periods. RESULTS: Two hundred fifty-two patients with COVID-19 have been admitted to the hospital. Seven of them had an HAI origin (6 in the preintervention period and 1 in the intervention period). One hundred forty-two HCP were infected with SARS-CoV-2. Of them, 22 (15.5%) were attributed to healthcare (2 in the emergency department and none in the critical care departments), and 120 (84.5%) were attributed to social relations in the workplace or during their non-work-related personal interactions. The accumulated incidence during the preintervention period was 22.3 for every 1000 HCP and 8.2 for every 1000 HCP during the intervention period. The relative risk was 0.37 (95% confidence interval, 0.25 to 0.55) and the attributable risk was -0.014 (95% confidence interval, -0.020 to -0.009). CONCLUSIONS: A program of control and prevention of HAIs complemented with the recommendation for the continuous use of a surgical mask in the workplace and social environments of HCP effectively decreased the risk of COVID-19 HAIs in admitted patients and HCP.

[Effectiveness of the first dose of BNT162b2 vaccine to preventing covid-19 in healthcare personnel.] / Efectividad de la primera dosis de vacuna BNT162b2 para prevenir la COVID-19 en personal sanitario.

OBJECTIVE: A first protective dose of vaccine may allow delaying the second dose in a context of low supply. The objective is to assess the effectiveness of a single dose of vaccine against SARS-CoV-2 (BNT162b2) after twelve days of its administration in healthcare personnel (HCP) of a Health Department. METHODS: A case-control study was made. HCP with suspected COVID-19 and HCP close contacts of COVID-19 cases were included between January 27 and February 7, 2021. They were PCR tested for SARS-CoV-2; those with positive PCR were considered cases and those with negative PCR were considered controls. The crude (VE) and adjusted (VEa) vaccine effectiveness to prevent COVID-19 cases and their 95% confidence interval were calculated using the formula VE = (1-Odds ratio) x 100. RESULTS: 268 HCP were included, of which 70 (26.1%) were considered cases and 198 (73.9%) controls. The frequency of vaccine exposure in cases was 55.7% vs. 69.7% in controls (p=0.035). The VEa of the first vaccine dose was 52.6% (95%CI: 1.1-77.3). The VEa in the subgroup of HCP studied for suspected disease was 74.6% (CI95%: 38.4-89.5). CONCLUSIONS: One dose of BNT162b2 vaccine against SARS-CoV-2 offers early protection after twelve days of administration. These data could be considered to adapt strategies and consider postponing the second dose in situations of limited vaccine supply in order to achieve the maximum number of people covered with a first dose.

OBJETIVO: Una primera dosis de vacuna protectora permitiría aplazar la segunda dosis en un contexto de suministro escaso. El objetivo de este trabajo fue conocer la efectividad de una dosis de vacuna frente a SARS-CoV-2 (BNT162b2) tras doce días de su administración en personal sanitario (PS) de un Departamento de Salud. METODOS: Se realizó un estudio de casos y controles. Se incluyó a PS con sospecha de COVID-19 y PS que tuvo contactos estrechos con casos de COVID-19 entre el 27 de enero y el 7 de febrero de 2021. Se les realizó una PCR para determinar SARS-CoV-2; aquellos con PCR positiva fueron considerados casos y aquellos con PCR negativa fueron considerados controles. Se calculó la efectividad vacunal cruda (EV) y ajustada (EVa) para prevenir casos de COVID-19 y su intervalo de confianza al 95%, mediante la fórmula EV = (1-Odds ratio) x 100. RESULTADOS: Fueron incluidos 268 PS, de los cuales 70 (26,1%) fueron considerados casos y 198 (73,9%) controles. La frecuencia de exposición a la vacuna en los casos fue del 55,7% frente al 69,7% en los controles (p=0,035). La EVa de la primera dosis de vacuna fue del 52,6% (IC95%: 1,1-77,3). La EVa en el subgrupo de PS estudiados por sospecha de enfermedad fue del 74,6% (IC95%: 38,4-89,5). CONCLUSIONES: Una dosis de vacuna BNT162b2 frente a SARS-CoV-2 ofrece protección temprana tras doce días de su administración. Estos datos podrían considerarse para adaptar estrategias y valorar aplazar la segunda dosis en situaciones de limitación de suministro de vacuna, con el fin de conseguir el máximo número de personas cubiertas con una primera dosis.

[Effectiveness of flu vaccine in the prevention of severe cases. Season 2018-2019]. / Efectividad de la vacuna de la gripe para prevenir casos graves. Temporada 2018/2019.

OBJECTIVE: To know the effectiveness of the 2018/2019 flu vaccine for the prevention of severe cases of flu in a tertiary hospital. METHOD: Case-control study. We included all patients hospitalized with influenza confirmed by laboratory during 2018/2019 season. Those who met the criteria of severe case of influenza (pneumonia, multiorgan failure, septic shock, ICU admission or death) were considered as cases. Non severe cases of influenza were included in the control group. We calculated the effectiveness of the raw and adjusted vaccine (to prevent severe cases of influenza) and its 95% confidence interval using formula VE=(1-odds ratio)×100. RESULTS: Effectiveness of flu vaccine adjusted by age group and comorbidities was 60.7% (20.5-80.5). In the analysis adjusted and restricted to each sex, age group and presence of comorbidities, the influenza vaccine had a positive effect in all groups and categories, with effectiveness in the age group 65 years or more being 55.0% (2.6-79.2). CONCLUSIONS: Flu vaccination reduced the severity of influenza in hospitalized patients. These findings should be taken into account to improve vaccination strategies and achieve better vaccination coverage in the high-risk population in order not only to decrease flu cases, but also their severity.

Frequency, Associated Risk Factors, and Characteristics of COVID-19 Among Healthcare Personnel in a Spanish Health Department.

INTRODUCTION: This study examines the frequency, associated factors, and characteristics of healthcare personnel coronavirus disease 2019 cases in a healthcare department that comprises a tertiary hospital and its associated 12 primary healthcare centers. METHODS: This study included healthcare personnel that showed symptoms or were in contact with a coronavirus disease 2019 case patient from March 2, 2020 to April 19, 2020. Their evolution and characteristics (age, sex, professional category, type of contact) were recorded. Correlations between the different characteristics and risk of developing coronavirus disease 2019 and severe coronavirus disease 2019 were analyzed using chi-square tests. Their magnitudes were quantified with ORs, AORs, and their 95% CIs using a logistic regression model. RESULTS: Of the 3,900 healthcare professionals in the department, 1,791 (45.9%) showed symptoms or were part of a contact tracing study. The prevalence of those with symptoms was 20.1% (784/3,900; 95% CI=18.8, 21.4), with coronavirus disease 2019 was 4.0% (156/3,900; 95% CI=3.4, 4.6), and with severe coronavirus disease 2019 was 0.5% (18/3,900; 95% CI=0.2, 0.7). The frequency of coronavirus disease 2019 in symptomatic healthcare personnel with a nonprotected exposure was 22.8% (112/491) and 13.7% (40/293) in those with a protected exposure (AOR=2.2, 95% CI=1.2, 3.9). The service in which the healthcare personnel performed their activity was not significantly associated with being diagnosed with coronavirus disease 2019. A total of 26.3% (10/38) of male healthcare personnel with coronavirus disease 2019 required hospitalization, compared with 6.8% (8/118) among female healthcare personnel (OR=4.9, 95% CI=1.8, 13.6). CONCLUSIONS: A surveillance and monitoring program centred on healthcare personnel enables an understanding of the risk factors that lead to coronavirus disease 2019 among this population. This knowledge allows the refinement of the strategies for disease control and prevention in healthcare personnel during the coronavirus disease 2019 pandemic.

Impacto de la pandemia de COVID-19 en los trabajadores sanitarios del servicio de urgencias de un hospital terciario / Impact of the COVID-19 pandemic on health care workers in a tertiary care hospital emergency department

OBJETIVO: Evaluar la efectividad de un programa de prevención y control de infecciones (PCI) por COVID-19 en los trabajadores sanitarios (TS) del servicio de urgencias de un hospital terciario. MÉTODO: Se recogió el número de casos confirmados de COVID-19 en TS del 2 de marzo al 12 de abril de 2020. Los TS fueron evaluados si presentaban síntomas o en el marco de estudios de contactos. Se recogió: edad, sexo, estamento, área trabajo y motivo contacto. Se comparó si existían diferencias entre los TS del SU y los del resto del Departamento de Salud (DS). RESULTADOS: De los 3.900 TS del DS (279 adscritos al SU), se evaluaron 1.744 TS (92 del SU). Presentaron síntomas 736 (52 del SU); 151 fueron confirmados COVID-19 (9 del SU). Dos casos del SU (22,2%) se atribuyeron a la asistencia sanitaria, y 7 (77,8%) a relaciones sociales en el lugar de trabajo o fuera de este. La prevalencia de TS con COVID-19 en el SU fue de un 3,2% (9/279), y en el resto de TS del 3,9% (142/3621). Entre los TS del SU y del resto del DS no hubo diferencias significativas en la prevalencia de afectados, ni entre los motivos de contacto. CONCLUSIONES: Teniendo en cuenta la prevalencia de TS con COVID-19 del SU respecto al resto del DS, el motivo del contacto de riesgo y su distribución en el tiempo, se puede considerar que el PCI orientado al SU fue efectivo

OBJECTIVE: To evaluate the effectiveness of a coronavirus disease 2019 (COVID-19) prevention and control program for health care workers in a tertiary care hospital emergency department (ED). METHODS: We recorded the number of confirmed COVID-19 workers in the ED on March 2, 2020, and April 12, 2020. Workers were screened if they had symptoms or were traced as contacts. Variables recorded were age, sex, staff position, work area, and reason for contact. We used the χ2 test to compare ED workers to workers in other areas of the health care system. RESULTS: Of the 3900 health care workers (279 in the ED), 1744 cases (92 in the ED) were included for analysis. A total of 736 workers (52 in the ED) had symptoms, and 151 had positive test results (9 from the ED). Two of the infections in the ED workers (22.2%) were attributed to patient contact and 7 (77.8%) to nonwork-related contact either in the workplace or in the community. The prevalence of COVID-19 among ED workers was 3.2% (9/279). The prevalence among other health system workers was 3.9% (142/3621). The differences in COVID-19 prevalencebetween the 2 groups was not significant. Nor was there a significant difference in the reasons for contact with the virus between the 2 groups. CONCLUSION: Based on the prevalence of COVID-19 among ED workers and other health care workers, the reasons for risk of contact with the virus, and the time frame for gathering the data, we conclude that the prevention and control measures in the ED have been effective

Impact of the COVID-19 pandemic on health care workers in a tertiary care hospital emergency department. / Impacto de la pandemia de COVID-19 en los trabajadores sanitarios del servicio de urgencias de un hospital terciario.

OBJECTIVES: To evaluate the effectiveness of a coronavirus disease 2019 (COVID-19) prevention and control program for health care workers in a tertiary care hospital emergency department (ED). MATERIAL AND METHODS: We recorded the number of confirmed COVID-19 workers in the ED on March 2, 2020, and April 12, 2020. Workers were screened if they had symptoms or were traced as contacts. Variables recorded were age, sex, staff position, work area, and reason for contact. We used the χ2 test to compare ED workers to workers in other areas of the health care system. RESULTS: Of the 3900 health care workers (279 in the ED), 1744 cases (92 in the ED) were included for analysis. A total of 736 workers (52 in the ED) had symptoms, and 151 had positive test results (9 from the ED). Two of the infections in the ED workers (22.2%) were attributed to patient contact and 7 (77.8%) to nonwork-related contact either in the workplace or in the community. The prevalence of COVID-19 among ED workers was 3.2% (9/279). The prevalence among other health system workers was 3.9% (142/3621). The differences in COVID-19 prevalence between the 2 groups was not significant. Nor was there a significant difference in the reasons for contact with the virus between the 2 groups. CONCLUSION: Based on the prevalence of COVID-19 among ED workers and other health care workers, the reasons for risk of contact with the virus, and the time frame for gathering the data, we conclude that the prevention and control measures in the ED have been effective.

OBJETIVO: Evaluar la efectividad de un programa de prevención y control de infecciones (PCI) por COVID-19 en los trabajadores sanitarios (TS) del servicio de urgencias de un hospital terciario. METODO: Se recogió el número de casos confirmados de COVID-19 en TS del 2 de marzo al 12 de abril de 2020. Los TS fueron evaluados si presentaban síntomas o en el marco de estudios de contactos. Se recogió: edad, sexo, estamento, área trabajo y motivo contacto. Se comparó si existían diferencias entre los TS del SU y los del resto del Departamento de Salud (DS). RESULTADOS: De los 3.900 TS del DS (279 adscritos al SU), se evaluaron 1.744 TS (92 del SU). Presentaron síntomas 736 (52 del SU); 151 fueron confirmados COVID-19 (9 del SU). Dos casos del SU (22,2%) se atribuyeron a la asistencia sanitaria, y 7 (77,8%) a relaciones sociales en el lugar de trabajo o fuera de este. La prevalencia de TS con COVID-19 en el SU fue de un 3,2% (9/279), y en el resto de TS del 3,9% (142/3621). Entre los TS del SU y del resto del DS no hubo diferencias significativas en la prevalencia de afectados, ni entre los motivos de contacto. CONCLUSIONES: Teniendo en cuenta la prevalencia de TS con COVID-19 del SU respecto al resto del DS, el motivo del contacto de riesgo y su distribución en el tiempo, se puede considerar que el PCI orientado al SU fue efectivo.

Estudio de sero-epidemiología de la infección por SARS-CoV-2 en profesionales sanitarios de un departamento sanitario / Sero-epidemiological study of SARS-CoV-2 infection among healthcare personnel in a healthcare department

OBJETIVO: Estimar la prevalencia de anticuerpos IgG frente a SARS-CoV-2 en profesionales sanitarios (PS) de un departamento sanitario (DS). MÉTODOS: Estudio de prevalencia. Se determinó la presencia de anticuerpos IgG frente a SARS-CoV-2 en los PS del DS. La determinación se realizó mediante la técnica de ELISA. El trabajo de campo se realizó del 24 de abril de 2020 al 8 de mayo de 2020. Se recogieron edad, sexo, estamento (facultativo, enfermería, etc.) y área de trabajo (atención primaria, urgencias, etc.). Se calculó la prevalencia de anticuerpos IgG frente a SARS-CoV-2 con su intervalo de confianza al 95% (IC95%). Para estudiar la asociación entre las características de los PS y la presencia de IgG se utilizó la prueba de la ji cuadrado y para cuantificar la magnitud de asociación se calculó la odds ratio (IC95%). RESULTADOS: De los 4.813 PS del DS participaron 4.179 (87,1%). De estos, el 73,3% (3.065) eran mujeres y el 26,7% (1.114) hombres. La prevalencia global de presencia de anticuerpos IgG frente a SARS-CoV-2 fue del 6,6% (IC95%: 5,8-7,3). Hubo diferencias estadísticamente significativas según estamento, oscilando del 8,7% (IC95%: 6,9-10,6) en facultativos al 3,2% (IC95%: 1,0-8,0) en otro personal no sanitario. El resto de características no se asociaron de forma significativa a la presencia de anticuerpos frente a SARS-CoV-2. CONCLUSIÓN: La frecuencia de infección por SARS-CoV-2 en PS es similar a la estimada para la población general en grandes ciudades en España, lo que orienta sobre la efectividad del programa de prevención y control de infecciones dirigido a los profesionales sanitarios en este DS

OBJECTIVE: Estimate IgG antibody prevalence against SARS-CoV-2 in healthcare personnel (HCP) of a healthcare department (HD). METHOD: Prevalence study. The presence of IgG antibodies against SARS-CoV-2 was determined in HCP of the HD. Enzyme linked immunosorbent assays (ELISA) tests were used. Field work took place from April 24, 2020 to May 8, 2020. The age, sex, occupation (physician, nurse, etc.) and the work area (Primary Care, Emergency Room, etc.) were gathered. The IgG antibody prevalence was then calculated with its 95% confidence interval (95%CI). To study the association between HCP characteristics and the presence IgG the Chi Square test was used, and to study the magnitude of association, the Odds Ratio (95%CI) was calculated. RESULTS: Of the 4813 HCP in the HD, 4179 (87,1%) participated. Of these, 73,3% (3065) were women and 26,7% (1114) men. The global prevalence of IgG antibodies against SARS-CoV-2 was 6,6% (95%CI: 5,8-7,3). There were statistically significant differences depending on the occupation, from 8,7% (95%CI: 6,9-10,6) on medics down to 3,2% (95%CI: 1,0-8,0) on personnel not associated with health care. The other characteristics did not associate significantly to antibody presence against SARS-CoV-2. CONCLUSION: The SARS-CoV-2 infection frequency in HCP is similar to the estimated in the general population for big cities in Spain. This highlights the effectiveness of the infection control and prevention programme in this healthcare department targeted at healthcare personnel

[Effectiveness of annual flu vaccination until week four of season 2018/2019]. / Efectividad de la vacuna de la gripe hasta la semana 4 de la temporada 2018/2019.

OBJECTIVE: Annual flu vaccination is the most effective measure to prevent the disease and its complications. Vaccine effectiveness (EV) varies from season to season, requiring annual re-evaluation. The objective of this work was to estimate the preliminary effectiveness of the influenza vaccine until epidemiological week 4 of the 2018/2019 season, in patients admitted to a third level hospital. METHODS: The Test Negative Design (TDN) was carried out at the Hospital General Universitario de Alicante. Patients admitted with laboratory-confirmed influenza (RT-PCR positive for any influenza virus, in clinical sample of nasopharyngeal aspirate) and those with clinical suspicion of influenza and negative RT-PCR, from week 40 to week 4 of the 2018/2019 influenza season, were considered as controls. The vaccination coverage was calculated in the cases and in the controls, and the EV with its 95% confidence interval using the formula: EV = (1-Odds Ratio) x 100. RESULTS: We included 524 patients: 58 cases and 466 controls. The overall EV for prevention of influenza cases was 42.5 % (95% CI -17.1 to 71.8) and for those over 1 year of age 63.7 % (95% CI 25.4 to 82.3). CONCLUSIONS: The 2018-2019 influenza vaccine is effective in preventing influenza cases in patients admitted up to week 4 of the 2018-19 season. Results are preliminary and may vary and should be re-evaluated at the end of the season.

OBJETIVO: La vacunación anual contra la gripe es la medida más efectiva para prevenir la enfermedad y sus complicaciones. La efectividad vacunal (EV) varía de una temporada a otra, lo que obliga a reevaluarla anualmente. El objetivo de este trabajo fue estimar la efectividad preliminar de la vacuna de la gripe hasta la semana epidemiológica 4 de la temporada 2018/2019, en pacientes ingresados en un hospital de tercer nivel. METODOS: Se realizó un estudio de casos y controles test negativos en el Hospital General Universitario de Alicante. Se consideró caso a los pacientes ingresados con gripe confirmada por laboratorio (RT-PCR positiva para cualquier virus influenza, en muestra clínica de aspirado nasofaríngeo) y como controles a aquellos con sospecha clínica de gripe y RT-PCR negativa, desde la semana 40 hasta la 4 de la temporada de gripe 2018/2019. Se calculó la cobertura de vacunación en los casos y en los controles, y la EV con su intervalo de confianza al 95% mediante la fórmula: EV= (1-Odds Ratio) x 100. RESULTADOS: Se incluyeron 524 pacientes: 58 casos y 466 controles. La EV global para la prevención de casos de gripe fue del 42,5 % (IC 95%: -17,1 a 71,8) y para mayores de 1 año de 63,7 % (IC 95%: 25,4 a 82,3). CONCLUSIONES: La vacuna de la gripe 2018-19 es efectiva para prevenir los casos de gripe en pacientes ingresados hasta la semana 4 de la temporada 2018-2019. Los resultados son preliminares y podrían variar, por lo que deberán reevaluarse al final de la temporada.

Efectividad de la vacuna de la gripe hasta la semana 4 de la temporada 2018/2019 / Effectiveness of annual flu vaccination until week four of season 2018/2019

OBJETIVO: La vacunación anual contra la gripe es la medida más efectiva para prevenir la enfermedad y sus complicaciones. La efectividad vacunal (EV) varía de una temporada a otra, lo que obliga a reevaluarla anualmente. El objetivo de este trabajo fue estimar la efectividad preliminar de la vacuna de la gripe hasta la semana epidemiológica 4 de la temporada 2018/2019, en pacientes ingresados en un hospital de tercer nivel. MÉTODOS: Se realizó un estudio de casos y controles test negativos en el Hospital General Universitario de Alicante. Se consideró caso a los pacientes ingresados con gripe confirmada por laboratorio (RT-PCR positiva para cualquier virus influenza, en muestra clínica de aspirado nasofaríngeo) y como controles a aquellos con sospecha clínica de gripe y RT-PCR negativa, desde la semana 40 hasta la 4 de la temporada de gripe 2018/2019. Se calculó la cobertura de vacunación en los casos y en los controles, y la EV con su intervalo de confianza al 95% mediante la fórmula: EV= (1-Odds Ratio) x 100. RESULTADOS: Se incluyeron 524 pacientes: 58 casos y 466 controles. La EV global para la prevención de casos de gripe fue del 42,5 % (IC 95%: -17,1 a 71,8) y para mayores de 1 año de 63,7 % (IC 95%: 25,4 a 82,3). CONCLUSIONES: La vacuna de la gripe 2018-19 es efectiva para prevenir los casos de gripe en pacientes ingresados hasta la semana 4 de la temporada 2018-2019. Los resultados son preliminares y podrían variar, por lo que deberán reevaluarse al final de la temporada

OBJECTIVE: Annual flu vaccination is the most effective measure to prevent the disease and its complications. Vaccine effectiveness (EV) varies from season to season, requiring annual re-evaluation. The objective of this work was to estimate the preliminary effectiveness of the influenza vaccine until epidemiological week 4 of the 2018/2019 season, in patients admitted to a third level hospital. METHODS: The Test Negative Design (TDN) was carried out at the Hospital General Universitario de Alicante. Patients admitted with laboratory-confirmed influenza (RT-PCR positive for any influenza virus, in clinical sample of nasopharyngeal aspirate) and those with clinical suspicion of influenza and negative RT-PCR, from week 40 to week 4 of the 2018/2019 influenza season, were considered as controls. The vaccination coverage was calculated in the cases and in the controls, and the EV with its 95% confidence interval using the formula: EV = (1-Odds Ratio) x 100. RESULTS: We included 524 patients: 58 cases and 466 controls. The overall EV for prevention of influenza cases was 42.5 % (95% CI -17.1 to 71.8) and for those over 1 year of age 63.7 % (95% CI 25.4 to 82.3). CONCLUSIONS: The 2018-2019 influenza vaccine is effective in preventing influenza cases in patients admitted up to week 4 of the 2018-19 season. Results are preliminary and may vary and should be re-evaluated at the end of the season