Capacitación en bioseguridad en las escuelas de Medicina en Venezuela: Análisis situacional y revisión de la literatura

El conocimiento y aplicación de las medidas de bioseguridad, en sus diferentes niveles, son de capital importancia en el ejercicio de las distintas profesiones relacionadas con atención en salud, y en la formación médica del trabajador sanitario resultan imprescindibles, para evitar la aparición de enfermedades infecciosas adquiribles durante el ejercicio profesional. Se revisaron las publicaciones y reglamentaciones acerca del tema, de manera general, y en el contexto de la realidad venezolana, se realizó la inspección del contenido en educación médica de los programas de las Facultades de Ciencias de la Salud de las Universidades venezolanas en relación con la oferta de conocimientos sobre los diferentes niveles de bioseguridad, medidas preventivas, uso de equipo de protección; habilidades y destrezas relacionadas con el tema, con base en la oferta y presencia de la asignatura Bioseguridad en los diseños curriculares de las diferentes Universidades.

The knowledge and application of biosafety measures, at their different levels, are of capital importance in the exercise of the different professions related to health care, and in the medical training of the health worker they are essential, to avoid the appearance of infectious diseases that can be acquirable during professional practice. The publications and regulations on the subject were reviewed, in a general way, and in the context of the Venezuelan reality, we performed an inspection of the content in medical education of the programs of the Faculties of Health Sciences of the Venezuelan Universities in relation to the offer of knowledge about the different levels of biosafety, preventive measures, use of protective equipment; abilities and skills related to the subject, based on the offer and presence of the Biosafety topic in the curricular designs of the different Universities

Notificación de agresiones por los trabajadores del Servicio Madrileño de Salud / Aggressions reported by the Madrid Health Service staff

Objetivo: conocer la prevalencia de agresiones notificadas por los trabajadores del Servicio Madrileño de Salud, saber la prevalencia de lesiones o alteraciones de la salud ocasionadas a los trabajadores por este motivo, e identificar los factores asociados a dichas agresiones. Método: estudio transversal en trabajadores del Servicio Madrileño de Salud (SERMAS) que notificaron una situación conflictiva/agresión en el periodo 2009-2018, a través de un registro habilitado por el SERMAS. Las variables estudiadas incluyeron datos del trabajador, del agresor, del incidente y sus consecuencias. Análisis descriptivo mediante el programa estadístico Stata. Resultados: se identificaron 5.587 notificaciones de situaciones conflictivas, el 89% correspondió a Atención Primaria (AP) y el 11% a Atención Especializada (AE). La prevalencia de alteraciones en el estado de salud sobre el total de notificaciones fue del 95% (IC 95%: 94-96), con un 97% (IC 95%: 95-98) en AE y un 95% (IC 95%: 94-95) en AP. En AE los trabajadores notificaron un 8% de agresiones físicas y 17% de coacciones, en AP fueron un 4% y un 25%, respectivamente. En Urgencias se notificaron un 12% de agresiones físicas frente al 4,6% del resto de servicios y un 13% de coacciones frente al 25%. En AE las enfermeras fueron los trabajadores que más agresiones notificaron y en AP fueron los facultativos. Conclusiones: en AP se notifican nueve veces más situaciones conflictivas que en AE. Las coacciones superan a las agresiones físicas. El personal de Enfermería y los trabajadores de urgencias son los profesionales que más agresiones notifican.(AU)

Objective: to understand the prevalence of aggressions reported by the Madrid Health Service staff, to learn about the prevalence of lesions or health alterations caused to workers for this reason, and to identify the factors associated with said aggressions. Method: a cross-sectional study conducted with workers of the Madrid Health Service (SERMAS) who reported a situation of conflict / aggression during the 2009-2018 period through a register provided by the SERMAS. The variables studied included: details of the worker, the aggressor, the incident and its consequences. There was descriptive analysis through the Stata statistical program. Results: in total, 5,587 reports of situations of conflict were identified: 89% from Primary Care (PC) and 11% from Specialized Care (SC). The prevalence of alterations in health status within all reports was 95% (CI 95%: 94-96), with 97% (CI 95%: 95-98) in SC and 95% (CI 95%: 94-95) in PC. Specialized Care staff reported 8% of physical aggressions and 17% of coercions; these were 4% and 25%, respectively, in PC. In the Emergency Unit, 12% of physical aggressions were reported vs. 4.6% in the rest of hospital units, and 13% of coercion vs. 25%. Nurses were the SC workers who reported more aggressions, vs. physicians in PC. Conclusions: nine times more situations of conflict are reported in Primary Care than in Specialized Care. Coercions are higher than physical agressions. Nursing staff and Emergency workers are the professionals reporting more aggressions.(AU)

Afección pericárdica y miocárdica tras infección por SARS-CoV-2: estudio descriptivo transversal en trabajadores sanitarios / Pericardial and myocardial involvement after SARS-CoV-2 infection: a cross-sectional descriptive study in healthcare workers

Introducción y objetivos Las secuelas cardiacas tras la infección por SARS-CoV-2 todavía están poco documentadas. Se realizó un estudio transversal en trabajadores sanitarios para estudiar la prevalencia de afección pericárdica y miocárdica tras la infección por SARS-CoV-2. Métodos Se estudió a 139 trabajadores sanitarios con infección previa confirmada por SARS-CoV-2. Los participantes se sometieron a evaluación clínica, electrocardiograma, laboratorio, incluido el perfil de células inmunitarias, y resonancia magnética cardiaca (RMC). El diagnóstico clínico de pericarditis se realizó ante la presencia de los criterios clásicos y el diagnóstico clínico de miocarditis ante la presencia de al menos 2 criterios de RMC. Resultados La mediana de edad fue de 52 (41–57) años, el 71,9% eran mujeres, y el 16,5% había sido hospitalizado previamente por neumonía por COVID-19. En la evaluación (10,4 [9,3–11,0] semanas después de los síntomas de infección), todos los participantes presentaban estabilidad hemodinámica. El 41,7% presentaba dolor torácico, disnea o palpitaciones; el 49,6%, alteraciones electrocardiográficas; el 7,9%, elevación de NT-proBNP; el 0,7%, elevación de troponina; y el 60,4%, alteraciones en la RMC (AU)

Introduction and objectives The cardiac sequelae of SARS-CoV-2 infection are still poorly documented. We conducted a cross-sectional study in healthcare workers to report evidence of pericardial and myocardial involvement after SARS-CoV-2 infection. Methods We studied 139 healthcare workers with confirmed past SARS-CoV-2 infection. Participants underwent clinical assessment, electrocardiography, and laboratory tests, including immune cell profiling and cardiac magnetic resonance (CMR). Clinically suspected pericarditis was diagnosed when classic criteria were present and clinically suspected myocarditis was based on the combination of at least 2 CMR criteria. Results Median age was 52 (41-57) years, 71.9% were women, and 16.5% were previously hospitalized for COVID-19 pneumonia. On examination (10.4 [9.3-11.0] weeks after infection-like symptoms), participants showed hemodynamic stability. Chest pain, dyspnea or palpitations were present in 41.7% participants, electrocardiographic abnormalities in 49.6%, NT-proBNP elevation in 7.9%, troponin in 0.7%, and CMR abnormalities in 60.4%. A total of 30.9% participants met criteria for either pericarditis and/or myocarditis: isolated pericarditis was diagnosed in 5.8%, myopericarditis in 7.9%, and isolated myocarditis in 17.3%. Most participants (73.2%) showed altered immune cell counts in blood, particularly decreased eosinophil (27.3%; P<.001) and increased cytotoxic T cell numbers (17.3%; P <.001). Clinically suspected pericarditis was associated (P <.005) with particularly elevated cytotoxic T cells and decreased eosinophil counts, while participants diagnosed with clinically suspected myopericarditis or myocarditis had lower (P <.05) neutrophil counts, natural killer-cells, and plasma cells. Conclusions Pericardial and myocardial involvement with clinical stability are frequent after SARS-CoV-2 infection and are associated with specific immune cell profiles (AU)

Hospital-Wide SARS-CoV-2 seroprevalence in health care workers in a Spanish teaching hospital.

INTRODUCTION: Hospital-wide SARS-CoV-2 seroprevalence is rarely explored and can identify areas of unexpected risk. We determined the seroprevalence against SARS-CoV-2 in all health care workers (HCW) at a hospital. METHODS: Cross-sectional study (14-27/04/2020). We determined SARS-CoV-2 IgG by ELISA in all HCW including external workers of a teaching hospital in Madrid. They were classified by professional category, working area, and risk for SARS-CoV-2 exposure. RESULTS: Among 2919 HCW, 2590 (88,7%) were evaluated. The mean age was 43.8 years (SD 11.1), and 73.9% were females. Globally, 818 (31.6%) workers were IgG positive with no differences for age, sex or previous diseases. Of these, 48.5% did not report previous symptoms. Seropositivity was more frequent in high- (33.1%) and medium- (33.8%) than in low-risk areas (25.8%, p=0.007), but not for hospitalization areas attending COVID-19 and non-COVID-19 patients (35.5 vs 38.3% p>0.05). HWC with a previous SARS-CoV2 PCR-positive test were IgG seropositive in 90.8%. By multivariate logistic regression analysis seropositivity was significantly associated with being physicians (OR 2.37, CI95% 1.61-3.49), nurses (OR 1.67, CI95% 1.14-2.46), nurse assistants (OR 1.84, CI95% 1.24-2.73), HCW working at COVID-19 hospitalization areas (OR 1.71, CI95% 1.22-2.40), non-COVID-19 hospitalization areas (OR 1.88, CI95% 1.30-2.73), and at the Emergency Room (OR 1.51, CI95% 1.01-2.27). CONCLUSIONS: Seroprevalence uncovered a high rate of infection previously unnoticed among HCW. Patients not suspected of having COVID-19 as well as asymptomatic HCW may be a relevant source for nosocomial SARS-CoV-2 transmission.

Hospital-Wide SARS-CoV-2 seroprevalence in health care workers in a Spanish teaching hospital / Seroprevalencia frente a SARS-CoV-2 en 2.590 trabajadores de un hospital universitario español

Introduction: Hospital-wide SARS-CoV-2 seroprevalence is rarely explored and can identify areas of unexpected risk. We determined the seroprevalence against SARS-CoV-2 in all health care workers (HCW) at a hospital. Methods: Cross-sectional study (14-27/04/2020). We determined SARS-CoV-2 IgG by ELISA in all HCW including external workers of a teaching hospital in Madrid. They were classified by professional category, working area, and risk for SARS-CoV-2 exposure. Results: Among 2919 HCW, 2590 (88,7%) were evaluated. The mean age was 43.8 years (SD 11.1), and 73.9% were females. Globally, 818 (31.6%) workers were IgG positive with no differences for age, sex or previous diseases. Of these, 48.5% did not report previous symptoms. Seropositivity was more frequent in high- (33.1%) and medium- (33.8%) than in low-risk areas (25.8%, p=0.007), but not for hospitalization areas attending COVID-19 and non-COVID-19 patients (35.5 vs 38.3% p>0.05). HWC with a previous SARS-CoV2 PCR-positive test were IgG seropositive in 90.8%. By multivariate logistic regression analysis seropositivity was significantly associated with being physicians (OR 2.37, CI95% 1.61–3.49), nurses (OR 1.67, CI95% 1.14–2.46), nurse assistants (OR 1.84, CI95% 1.24–2.73), HCW working at COVID-19 hospitalization areas (OR 1.71, CI95% 1.22–2.40), non-COVID-19 hospitalization areas (OR 1.88, CI95% 1.30–2.73), and at the Emergency Room (OR 1.51, CI95% 1.01–2.27). Conclusions: Seroprevalence uncovered a high rate of infection previously unnoticed among HCW. Patients not suspected of having COVID-19 as well as asymptomatic HCW may be a relevant source for nosocomial SARS-CoV-2 transmission.(AU)

Introducción: Los estudios de seroprevalencia frente a SARS-CoV-2 en los trabajadores sanitarios (TS) permiten identificar áreas de riesgo inesperado en los hospitales. Métodos: Estudio transversal (14-27/04/2020). Se determinó IgG frente a SARS-CoV-2 mediante ELISA en todos los TS, incluidos los externos, de un hospital universitario de Madrid. Se clasificaron por categoría profesional, área de trabajo y riesgo de exposición al SARS-CoV-2. Resultados: Entre 2.919 TS, se evaluaron 2.590 (88,7%); edad media 43,8años (DE11,1) y 73,9% mujeres. Globalmente, 818 (31,6%) trabajadores tuvieron IgG positiva, sin diferencias por edad, sexo o enfermedades previas. De estos, el 48,5% no comunicaron síntomas previos. La seropositividad fue más frecuente en las áreas de alto (33,1%) y medio (33,8%) que en las de bajo riesgo (25,8%, p=0,007), pero similar en las áreas de hospitalización que atendían a pacientes con y sin COVID-19 (35,5 vs 38,3%, p>0,05). El 90,8% de los TS con PCR previa positiva frente a SARS-CoV-2 tuvieron IgG positiva. Por análisis multivariante, la seropositividad se asoció con ser médico (OR2,37, IC95%: 1,61-3,49), enfermero (OR1,67, IC95%: 1,14-2,46), auxiliar de enfermería (OR1,84, IC95%: 1,24-2,73), trabajar en áreas de hospitalización COVID-19 (OR1,71, IC95%: 1,22-2,40) y no COVID-19 (OR1,88, IC95%: 1,30-2,73) y en Urgencias (OR1,51, IC95%: 1,01-2,27). Conclusiones: El estudio de seroprevalencia desveló una alta tasa de infección que pasó desapercibida entre los trabajadores sanitarios. Los pacientes sin sospecha clínica de COVID-19 y los trabajadores sanitarios asintomáticos pueden ser una fuente importante de transmisión nosocomial del SARS-CoV-2.(AU)

Pericardial and myocardial involvement after SARS-CoV-2 infection: a cross-sectional descriptive study in healthcare workers.

INTRODUCTION AND OBJECTIVES: The cardiac sequelae of SARS-CoV-2 infection are still poorly documented. We conducted a cross-sectional study in healthcare workers to report evidence of pericardial and myocardial involvement after SARS-CoV-2 infection. METHODS: We studied 139 healthcare workers with confirmed past SARS-CoV-2 infection. Participants underwent clinical assessment, electrocardiography, and laboratory tests, including immune cell profiling and cardiac magnetic resonance (CMR). Clinically suspected pericarditis was diagnosed when classic criteria were present and clinically suspected myocarditis was based on the combination of at least 2 CMR criteria. RESULTS: Median age was 52 (41-57) years, 71.9% were women, and 16.5% were previously hospitalized for COVID-19 pneumonia. On examination (10.4 [9.3-11.0] weeks after infection-like symptoms), participants showed hemodynamic stability. Chest pain, dyspnea or palpitations were present in 41.7% participants, electrocardiographic abnormalities in 49.6%, NT-proBNP elevation in 7.9%, troponin in 0.7%, and CMR abnormalities in 60.4%. A total of 30.9% participants met criteria for either pericarditis and/or myocarditis: isolated pericarditis was diagnosed in 5.8%, myopericarditis in 7.9%, and isolated myocarditis in 17.3%. Most participants (73.2%) showed altered immune cell counts in blood, particularly decreased eosinophil (27.3%; P<.001) and increased cytotoxic T cell numbers (17.3%; P <.001). Clinically suspected pericarditis was associated (P <.005) with particularly elevated cytotoxic T cells and decreased eosinophil counts, while participants diagnosed with clinically suspected myopericarditis or myocarditis had lower (P <.05) neutrophil counts, natural killer-cells, and plasma cells. CONCLUSIONS: Pericardial and myocardial involvement with clinical stability are frequent after SARS-CoV-2 infection and are associated with specific immune cell profiles.

Principales características clínicas y epidemiológicas de trabajadores de la salud diagnosticados con COVID-19 en Santiago de Cuba / Main clinical and epidemiologic characteristics of health workers diagnosed with COVID-19 in Santiago de Cuba

Introducción: La COVID- 19 tiene repercusión en el sistema de salud pública del país y en personal sanitario. Objetivo: Describir algunas características clínicas y epidemiológicas del personal de salud diagnosticado con COVID-19 en un área de salud de Santiago de Cuba. Métodos: Se realizó un estudio descriptivo y retrospectivo de 19 trabajadores de la salud del Policlínico Docente Ramón López Peña de Santiago de Cuba, diagnosticados con la COVID-19 en el período febrero-abril de 2021. Las variables descritas fueron: edad, sexo, categoría ocupacional, comorbilidades, fuente de infección, síntomas y evolución. Resultados: Predominaron las féminas entre 40 y 59 años de edad (36,8 %), la fuente de infección comunitaria (52,6 %), los médicos como el personal más afectado (47,3 %) y las manifestaciones respiratorias (47,3 %); asimismo, 94,7 % de los afectados egresaron vivos y hubo un solo fallecido. Conclusiones: A pesar de la baja prevalencia de la COVID-19 en el personal de salud, se deben extremar las medidas de bioseguridad implementadas en cada institución para evitar nuevos contagios.

Introduction: The COVID-19 has repercussion in the public health system of the country and in health personnel. Objective: To describe some clinical and epidemiologic characteristics of the health personnel diagnosed with COVID- 19 in a health area of Santiago de Cuba. Methods: A descriptive and retrospective study of 19 health workers of Ramón López Peña Teaching Polyclinic in Santiago de Cuba was carried out. They were diagnosed with the COVID-19 during February-April, 2021. The described variables were: age, sex, occupational category, comorbidities, infection source, symptoms and clinical course. Results: There was a prevalence of the females between 40 and 59 years (36.8 %), community source of infection (52.6 %), doctors as the most affected health staff (47.3 %) and respiratory signs (47.3 %); also, 94.7 % of the affected patients were alive when discharged from the hospital and there was only one dead patient. Conclusions: In spite of the low prevalence of the COVID-19 in the health staff, the biosecurity measures implemented in each institution to avoid new infections should be maximized.

COVID-19 vaccination among Spanish nephrologists: Acceptance and side effects.

INTRODUCTION: Four vaccines against Covid-19 have been approved to date. Their acceptance and safety have not been addressed on healthcare workers. The aim of the present study is to evaluate vaccination rates and side effects among Spanish nephrologists. METHODS: All the Spanish nephrologists were invited to participate in this survey. Data on demographics, Covid-19 infection status, received vaccine doses and side effects were collected. Acceptance and side effects were analyzed for Covid-19 vaccination. Factors associated to vaccination were assessed and a multivariate adjusted model was constructed to determine independent predictors for Covid-19 vaccine side effects. RESULTS: A total of 708 nephrologists answered the survey (460 [65%] women, mean age 44±11 years). Six-hundred and eight (86%) had received the first dose and 513 (72%) were fully vaccinated. Most of the subjects (565, 93%) received BNT162b2 (Pfizer-BioNTech®) vaccine. Among vaccinated nephrologists, 453 (75%) presented any side effect; the most frequent was local reaction (68%), followed by myalgia (44%), tiredness (39%) and headache (34%). Age (OR 0.97, 95%CI [0.95-0.99], p<0.0001) and prior Covid-19 infection (OR 2.37, 95%CI [1.27-4.42], p=0.007) were independent predictors for developing side effects with Covid-19 vaccine. Overall side effects were similar with both vaccines, being myalgia (p=0.006) and tiredness (p=0.032) more frequent with the Pfizer-BioNTech® one. CONCLUSION: Age and prior Covid-19 infection were predictors of vaccination side effects among Spanish nephrologists.

Reinfección sars-cov-2 vs falso positivo en trabajadora sanitaria / SARS-CoV-2 reinfection vs. false positive in a health worker

Se describe un caso de una trabajadora sanitaria de 30 años de edad que presenta un cuadro compatible con reinfección por SARS-CoV-2 o con falso positivo de prueba diagnóstica de infección activa. Se presenta la secuencia temporal de pruebas realizadas y sintomatología presentada. Los primeros casos de enfermedad por SARS-CoV-2 se reportaron en diciembre de 2019 y hasta la fecha el conocimiento de las pruebas diagnósticas está en continua revisión (AU)

It is described a case of a 30-year-old health worker who presents a clinical state compatible with reinfection by SARS-CoV-2 or with a false positive diagnostic test for active infection. The temporal sequence of tests performed and symptoms presented are described. The first cases of SARS-CoV-2 disease were reported in December 2019 and to date, knowledge of the diagnostic tests is under continuous review (AU)

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.

Hospital-Wide SARS-CoV-2 seroprevalence in health care workers in a Spanish teaching hospital.

INTRODUCTION: Hospital-wide SARS-CoV-2 seroprevalence is rarely explored and can identify areas of unexpected risk. We determined the seroprevalence against SARS-CoV-2 in all health care workers (HCW) at a hospital. METHODS: Cross-sectional study (14-27/04/2020). We determined SARS-CoV-2 IgG by ELISA in all HCW including external workers of a teaching hospital in Madrid. They were classified by professional category, working area, and risk for SARS-CoV-2 exposure. RESULTS: Among 2919 HCW, 2590 (88,7%) were evaluated. The mean age was 43.8 years (SD 11.1), and 73.9% were females. Globally, 818 (31.6%) workers were IgG positive with no differences for age, sex or previous diseases. Of these, 48.5% did not report previous symptoms. Seropositivity was more frequent in high- (33.1%) and medium- (33.8%) than in low-risk areas (25.8%, p=0.007), but not for hospitalization areas attending COVID-19 and non-COVID-19 patients (35.5 vs 38.3% p>0.05). HWC with a previous SARS-CoV2 PCR-positive test were IgG seropositive in 90.8%. By multivariate logistic regression analysis seropositivity was significantly associated with being physicians (OR 2.37, CI95% 1.61-3.49), nurses (OR 1.67, CI95% 1.14-2.46), nurse assistants (OR 1.84, CI95% 1.24-2.73), HCW working at COVID-19 hospitalization areas (OR 1.71, CI95% 1.22-2.40), non-COVID-19 hospitalization areas (OR 1.88, CI95% 1.30-2.73), and at the Emergency Room (OR 1.51, CI95% 1.01-2.27). CONCLUSIONS: Seroprevalence uncovered a high rate of infection previously unnoticed among HCW. Patients not suspected of having COVID-19 as well as asymptomatic HCW may be a relevant source for nosocomial SARS-CoV-2 transmission.

[Prevalence of physical activity in primary health care workers of Catalonia]. / Prevalencia de actividad física en profesionales de atención primaria de Cataluña.

INTRODUCTION: Physical inactivity is the fourth leading risk factor for global mortality, and a significant percentage of the world population does not perform the necessary physical activity for health benefits. Certain professional groups are seen as an example for the general population with whom they interact. Prevalence of physical activity in health workers, one of these reference groups, is mainly unknown. The aim of this study has been to assess the prevalence of physical activity levels in Primary Health Care professionals. MATERIAL AND METHODS: A study was conducted on the physical activity levels in Primary Health Care workers who came voluntarily for a medical examination in 2014, and completed the short version of the International Physical Activity Questionnaire activity. RESULTS: A low level of physical activity was reported by 26.5% of those taking part, with 31.5% of the medical group indicating a low level of activity, followed by support staff (28.1%), nurses (24.7%), and finally the administrative staff (19.0%). CONCLUSIONS: The physical activity levels of Primary Health Care staff are significantly different from those of the general reference population. The latter has a higher percentage of physical activity of mild to moderate intensity, and below the level of physical activity of high intensity. Although there seems to be a tendency to significantly lower physical activity in other health groups, we do not have sufficiently reliable data to compare them.

[Usefulness of Quantiferon-TB Gold in Tube® in screening for latent tuberculosis infection in health workers]. / Utilidad del Quantiferon-TB Gold in Tube(®) en el cribado de la infección latente tuberculosa en personal sanitario.

INTRODUCTION: Healthcare workers (HW) are considered a risk group for exposure to tuberculosis. Screening for latent tuberculosis infection (LTBI) is mandatory in all HW. The Tuberculin test (TT) has been used up until now for LTBI screening, but gives a high number of false positives, especially in patients vaccinated with BCG. Diagnostic methods based on detection of specific gamma interferon (IGRA) have recently appeared on the market in order to improve these drawbacks, but pose other dilemmas. The aim of this study is to determine the agreement between the two types of test and to carry out a cost-benefit study of the possible diagnostic strategies. MATERIAL AND METHODS: All newly hired HW by the Hospital Universitari Mútua Terrassa between January 2010 and October 2011 we were included in the study, as well as those who had their occupational review. Workers who been in contact with patients admitted with tuberculosis before the initial isolation were also tested. In all cases a parallel TT and serum QuantiFeron-TB Gold-in-Tube(®) (QF-G-IT) assays were performed. TB disease was ruled out in all professional by chest X-ray. The TT was considered positive when it was equal to or more than 10mm and if the QF-G-IT was 0.35 IU/mL. A cost-effectiveness analysis was designed with three possible strategies to detect LTBI in order to find the one with the best cost-benefit. RESULTS: A total of 226 HW were studied, with a mean age 30.65 ± 16, of whom 44 (19.4%) had previous BCG vaccination history, and 8 (3.5%) unknown. The TT was positive in 33 (14.6%) cases and the QF-G-IT in 17 (7.5%). The values of the TT and QF-G-IT were both positive in 15 cases. In 18 (8%) The TT was positive in 18 (8%) of cases with a negative QF-G-IT value. The agreement between the two tests was 91%, with a Kappa of 0.55. In vaccinated cases, the correlation was 70.5%, with a Kappa of 0.33, while in unvaccinated it was 98.9% with a Kappa of 0.65. The cheapest screening strategies for LTBI diagnosis were those based on TT, but followed closely by the strategy based on TT with reconfirmation of positives with QF-G-IT. CONCLUSIONS: QF-G-IT seems to be a very sensitive technique to detect LTBI and allows false positives due to TT to be detected, particularly in BCG vaccinated HW. In this group QF-G-IT could be the ideal test to detect truly infected staff, and avoid unnecessary chemoprophylaxis. The most cost-benefit strategy was those based in TT with reconfirmation or rejection of positive cases by QF-G-IT.

[Antibiotic ointments and methicillin-resistant Staphylococcus aureus with a reservoir in a healthcare worker in a tertiary hospital]. / Staphylococcus aureus resistente a la meticilina y a descolonizadores habituales con reservorio en un trabajador sanitario en un hospital de tercer nivel.

BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) has become an important hospital-acquired pathogen, with transfer of the organism from a carrier or infected patient to uninfected patients by the hands or clothing of staff as the main mode of transmission. METHODS: Investigation of a cluster of new cases of MRSA resistant to mupirocin and fusidic acid, using epidemiological and microbiological resources. RESULTS: From September 2010 to February 2012, sixteen patients had at least one culture positive for MRSA resistant to mupirocin and fusidic acid. Some not apparently related cases and outbreaks appeared. By analysing cultures taken from patients and staff using pulsed-field gel electrophoresis, it was demonstrated that most likely this situation was started by an auxiliary nurse who was a carrier of the MRSA. Healthcare worker decontamination using oral antibiotic therapy was unsuccessful. Eventually, the situation was controlled by placing the carrier in a different job, with no further cases to date (September, 2012). CONCLUSION: This report illustrates the risk of nosocomial transmission linked to care delivered by healthcare workers.