RESUMEN
BACKGROUND: Healthcare workers are a high-risk population for SARS-CoV2 infection. For capacity planning of healthcare providers and to optimize protection of healthcare workers (HCW) in SARS-CoV2 pandemics, it is essential to know the risk of infection and potential immunity status of staff dealing with COVID-19 patients. MATERIALS AND METHODS: We examined seropravalence of SARS-CoV2 IgM/IgG antibodies (AB) in HCW of a region with the highest rate of infection (1570/100,000) during COVID-19 pandemic in Germany, 4 months after its start. Employees of a nonmedical company (MU) served as control group. Demographic data, medical history and working situation were recorded. RESULTS: A total of 1838 HCW and 986 MU volunteered to participate. Seroprevalence for SARS-CoV2 in HCW was 15.1% and 3.7% in MU. Among HCWs, nurses had a seropositivity of 20.0%, ICU personnel 20.3%, housekeepers 19.3%, physicians 12.0%, medical services (e.g., radiology, physiotherapy) 11.3%, administration 7.1% and technical services 6%. Symptoms typical for COVID-19 were not experienced by 10% of seropositive HCWs. CONCLUSION: Seroprevalence of SARS-CoV2 antibodies in HCW of a region heavily affected by COVID-19 is with 15.1% significantly higher than in a control group of nonmedical staff with 3.7%. Infection rate in HCW was higher in staff with close contact to infected patients. Seropositivity in ICU personnel is higher than in other clinical professions. The occupational risk for housekeepers seems to be underestimated.
Asunto(s)
COVID-19 , SARS-CoV-2 , Alemania , Humanos , Unidades de Cuidados Intensivos , Pandemias , Estudios SeroepidemiológicosRESUMEN
PURPOSE: In Europe, intravenous fosfomycin (IV) is used particularly in difficult-to-treat or complex infections, caused by both Gram-positive and Gram-negative pathogens including multidrug-resistant strains. Here, we investigated the efficacy and safety of intravenous fosfomycin under real-life conditions. METHODS: Prospective, multi-center, and non-interventional study in patients with bacterial infections from 20 intensive care units (ICU) in Germany and Austria (NCT01173575). RESULTS: Overall, 209 patients were included (77 females, 132 males, mean age: 59 ± 16 years), 194 of which were treated in intensive care (APACHE II score at the beginning of fosfomycin therapy: 23 ± 8). Main indications (± bacteremia or sepsis) were infections of the CNS (21.5%), community- (CAP) and hospital-acquired pneumonia (HAP)/ventilator-associated pneumonia (VAP, 15.3%), bone and joint infections (BJI, 11%), abdominal infections (11%), and bacteremia (10.5%). Most frequently identified pathogens were S. aureus (22.3%), S. epidermidis (14.2%), Enterococcus spp. (10.8%), E. coli (12.3%) and Klebsiella spp. (7.7%). At least one multidrug-resistant (MDR) pathogen was isolated from 51 patients (24.4%). Fosfomycin was administered with an average daily dose of 13.7 ± 3.5 g over 12.4 ± 8.6 days, almost exclusively (99%) in combination with other antibiotics. The overall clinical success was favorable in 81.3% (148/182) of cases, and in 84.8% (39/46) of patients with ≥ 1 MDR pathogen. Noteworthy, 16.3% (34/209) of patients developed at least one, in the majority of cases non-serious, adverse drug reaction during fosfomycin therapy. CONCLUSION: Our data suggest that IV fosfomycin is an effective and safe combination partner for the treatment of a broad spectrum of severe bacterial infections in critically ill patients.