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논문 기본 정보

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학술저널
저자정보
Kim Chang Seong (Department of Nephrology Chonnam National University Hospital Gwangju Korea.Department of Internal Medicine Chonnam National University Medical School Gwangju Korea.) Kim Uh Jin (Department of Internal Medicine Chonnam National University Medical School Gwangju Korea.Department of Infectious Diseases Chonnam National University Hospital Gwangju Korea.) Lee Yoonjung (Department of Infectious Diseases Chonnam National University Hospital Gwangju Korea.) Lee Unhee (Department of Infection Control Unit Chonnam National University Hospital Gwangju Korea.) Choi Okja (Department of Infection Control Unit Chonnam National University Hospital Gwangju Korea.) Kim Sun-Hee (Division of Emerging Infectious Disease Health and Environmental Research Institute of Gwangju City Gwangju Korea.) Lee Kwangho (Division of Emerging Infectious Disease Department of Infectious Disease Research Health and Environment Research Institute of Gwangju Gwangju Korea.) Chung Yoon-Seok (Division of Infectious Disease Diagnosis Control Honam Regional Center for Disease Control and Prevention Korea Diseases Control and Prevention Agency Gwangju Korea.) Choi Hong Sang (Department of Nephrology Chonnam National University Hospital Gwangju Korea.Department of Internal Medicine Chonnam National University Medical School Gwangju Korea.) Bae Eun Hui (Department of Nephrology Chonnam National University Hospital Gwangju Korea.Department of Internal Medicine Chonnam National University Medical School Gwangju Korea.) Ma Seong Kwon (Department of Nephrology Chonnam National University Hospital Gwangju Korea.Department of Internal Medicine Chonnam National University Medical School Gwangju Korea.) Kim Seong Eun (Department of Internal Medicine Chonnam National University Medical School Gwangju Korea.Department of Infectious Diseases Chonnam National University Hospital Gwangju Korea.) Kang Seung-Ji (Department of Internal Medicine Chonnam National University Medical School Gwangju Korea.Department of Infectious Diseases Chonnam National University Hospital Gwangju Korea.) Jung Sook-In (Department of Internal Medicine Chonnam National University Medical School Gwangju Korea.Department of Infectious Diseases Chonnam National University Hospital Gwangju Korea.) Kim Soo Wan (Department of Nephrology Chonnam National University Hospital Gwangju Korea.Department of Internal Medicine Chonnam National University Medical School Gwangju Korea.) Park Kyung-Hwa (Department of Internal Medicine Chonnam National University Medical School Gwangju Korea.Department of Infectious Diseases Chonnam National University Hospital Gwangju Korea.Department of Infection Co)
저널정보
대한감염학회 Infection and Chemotherapy Infection and Chemotherapy 제55권 제1호
발행연도
2023.3
수록면
42 - 49 (8page)
DOI
10.3947/ic.2022.0124

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Background Determination of the release from isolation for coronavirus disease 2019 (COVID-19) in immunocompromised patients who need additional hospitalization for treatment of non-COVID-19 related disease is important to prevent nosocomial transmission. However, there is insufficient evidence for an extended isolation period. Materials and Methods In September 2021, when the Delta variant was dominant, a nosocomial outbreak of COVID-19 occurred in the nephrology ward of a tertiary hospital in Gwangju, Korea. We conducted epidemiological investigations and whole-genome sequencing (WGS) of this virus. Results A man who underwent kidney transplantation was admitted to our hospital for the treatment of acute kidney injury. He was diagnosed with asymptomatic COVID-19 infection during a pre-admission screening test on September 1, 2021 and underwent isolation. After 10 days of isolation in the COVID-19-designated ward, he was transferred to the general nephrology ward. He underwent steroid pulse therapy (September 17 to September 23, >60 mg/day prednisolone) due to acute T-cell rejection. On September 28, 2021, the first patient with COVID-19 was identified in the nephrology ward, and a rapid-response team was activated to identify additional patients with COVID-19 and prevent the spread of COVID-19. Epidemiological investigations revealed that 12 patients, two caregivers, and three healthcare workers from the nephrology ward were diagnosed with COVID-19. The WGS of specimens from 14 nosocomial outbreak samples and released an index patient exhibited the same Delta variant originating from the B.1.617.2 lineage. This hospital-acquired COVID-19 outbreak in the nephrology ward resulted in two (11.7%) deaths in patients who underwent kidney transplantation. Conclusion We demonstrated that an immunocompromised patient can cause a nosocomial outbreak due to the prolonged shedding of infectious viruses. Prolonged isolation in patients under active immunosuppressive therapy may be necessary to prevent transmission, especially in the hospital setting.
#COVID-19 #Cross infection #Disease outbreaks #Isolation #Immunocompromised hosts

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