Genetic testing and serological screening for SARS-CoV-2 infection in a COVID-19 outbreak in a nursing facility in Japan

BMC Infectious Diseases

Hideyuki Ikematsu¹  Yosuke Tanaka²  Nobuto Terazawa²  Hitoshi Nakashima²  Koichi Akashi³  Yong Chong³  Naoki Tani³  Nobuyuki Shimono⁴ 

[1] Japan Physicians Association, Tokyo, Japan;Medical Corporation SOUSEIKAI, Kanenokuma Hospital, Fukuoka, Japan;Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences (The First Department of Internal Medicine), 3-1-1 Maidashi, Higashi-Ku, 812-8582, Fukuoka, Japan;Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences (The First Department of Internal Medicine), 3-1-1 Maidashi, Higashi-Ku, 812-8582, Fukuoka, Japan;Center for the Study of Global Infection, Kyushu University Hospital, Fukuoka, Japan;

关键词: PCR testing;    Antibody testing;    COVID-19 outbreak;    Nursing facility;    SARS-CoV-2;   

DOI  :  10.1186/s12879-021-05972-5

来源: Springer

【 摘 要 】

BackgroundThe Pandemic of coronavirus disease (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has critically impacted the spread of infection within nursing facilities. We evaluated the usefulness of genetic and serological tests conducted during a COVID-19 outbreak in a nursing facility in Japan.MethodsAfter the first identification of SARS-CoV-2 infection, a comprehensive, facility- and/or unit-wide PCR testing from nasopharyngeal swabs was repeatedly performed in a three-unit facility including 99 residents with dementia and 53 healthcare personnel. Additionally, PCR testing was conducted separately for residents and staff with fever of ≥37.5 °C. Facility-wide serological testing, including rapid kit testing and quantitative assay, was conducted twice over 1 month apart.ResultsA total of 322 PCR and 257 antibody tests were performed. 37 (24.3%) of the 152 individuals (25/99 residents, 25.3%; 12/53 staff, 22.6%) were identified as PCR-positive. Seven residents died with a mortality of 7.1% (7/99). Among the 37 individuals, 10 (27.0%) were asymptomatic at the time of testing. PCR positivity was concentrated on one unit (Unit 1) (20/30 residents, 66.7%; 9/14 staff, 64.3%). The other units showed a limited spread of infection. In unit-wide and separate tests, PCR positivity detection was highly prevalent (22.9 and 44.4%, respectively) in Unit 1, compared with that in the other units. Serological testing identified two additional infected residents with a negative PCR result and showed that no staff was newly identified as infected.ConclusionsThorough PCR testing, in combination with comprehensive and separate tests, is critical for managing COVID-19 outbreaks in nursing facilities, particularly, in units considered an epicenter. Serological testing is also beneficial for tracing contacts, confirming the number of infected individuals, and authorizing the termination of the outbreak.

【 授权许可】

CC BY