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Table 1 Definitions for the likelihood that healthcare worker infections were the result of nosocomial transmission

From: Combining epidemiological data and whole genome sequencing to understand SARS-CoV-2 transmission dynamics in a large tertiary care hospital during the first COVID-19 wave in The Netherlands focusing on healthcare workers

Likelihood

 

WGS result available

WGS clustera

HCW and/or patient exposureb

Community exposureb,c

Confirmed transmission

A

SARS-CoV-2 PCR positive HCW with WGS result

Part of a non-regional sequence cluster

With exposure to other SARS-CoV-2 positive HCW and/or patients < 14 days before symptom onset

And without known exposure in the community

Probable transmission

A

SARS-CoV-2 PCR positive HCW with WGS result

Part of a regional sequence cluster

With exposure to other SARS-CoV-2 positive HCW and/or patients < 14 days before symptom onset

And without known exposure in the community

B

SARS-CoV-2 PCR positive HCW with WGS result

Part of a non-regional sequence cluster

With exposure to other SARS-CoV-2 positive HCW and/or patients < 14 days of symptoms onset

And with known exposure in the community

Possible transmission

A

SARS-CoV-2 PCR positive HCW without WGS result

 

With exposure to other SARS-CoV-2 positive HCW and/or patients, who were part of a WGS confirmed non-regional transmission cluster with ≥ 3 transmissions, < 14 days before symptom onset

And without known exposure in the community

Transmission not confirmed

A

SARS-CoV-2 PCR positive HCW with WGS result

Part of a non-regional sequence cluster

But is the index case of the epidemiological cluster based on first date of symptom onset

And without known community exposure

B

SARS-CoV-2 PCR positive HCW with WGS result

Part of a regional sequence cluster

With exposure to other SARS-CoV-2 positive HCW and/or patients < 14 days before symptom onset

And with known exposure in the community

C

SARS-CoV-2 PCR positive HCW with WGS result

Part of a regional or non-regional sequence cluster or a unique viral strain

With exposure to other SARS-CoV-2 positive HCW and/or patients, without WGS result, < 14 days before symptom onset

And without known exposure in the community

D

SARS-CoV-2 PCR positive HCW without WGS result

 

With known exposure to other SARS-CoV-2 positive HCW and/or patients < 14 days before symptom onset

 

No transmission

A

SARS-CoV-2 PCR positive HCW with WGS result

Part of a non-regional sequence cluster

But is the index case of the epidemiological cluster based on first date of symptom onset

And with known exposure in the community

B

SARS-CoV-2 PCR positive HCW with WGS result

Part of a regional sequence cluster

But is the index case of the epidemiological cluster based on first date of symptom onset

 

C

SARS-CoV-2 PCR positive HCW with WGS result

Part of a non-regional sequence cluster

But with household member (HCW) in the same epidemiological and genetic cluster

 

D

SARS-CoV-2 PCR positive HCW with WGS result

With a unique viral strain

And without known exposure to SARS-CoV-2 positive HCW and/or patients

 

E

SARS-CoV-2 PCR positive HCW without WGS result

 

And without known exposure to SARS-CoV-2 positive HCW and/or patients

 
  1. aRegional clusters were defined as sequence clusters which were identified in ≥ 5 primary COVID-19 patients, whereby patients with a positive SARS-CoV-2 test upon admission were regarded as primary COVID-19 patients. All other clusters were defined as non-regional
  2. bExposure to SARS-CoV-2 positive persons is defined as exposure < 14 days before symptom onset
  3. cCommunity exposure is referred to as known exposure to SARS-CoV-2 infected individuals via household contacts, family, friends, events, and/or travels
  4. HCW = healthcare worker, WGS = whole genome sequencing
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Antimicrobial Resistance & Infection Control

ISSN: 2047-2994

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