Long-term symptoms after SARS-CoV-2 infection in a cohort of hospital employees: duration and predictive factors.

PURPOSE: To evaluate the frequency, duration and patterns of long-term coronavirus disease 2019 (COVID-19) symptoms and to analyse risk factors for long-lasting COVID-19 sequelae among a cohort of hospital employees (HEs). METHODS: We conducted a survey regarding persistent COVID-19 related symptoms with all HEs from three medical centres in Cologne, Germany, who were tested SARS-CoV-2 PCR positive from March 2020 until May 2021. Duration of symptoms and possible risk factors for protracted COVID-19 course were analysed. RESULTS: Of 221 included HEs, a number of 104 HEs (47.1%) reported at least one persisting symptom for more than 90 days after initial SARS-CoV-2 detection. Each one cycle higher initial Ct value significantly increased the chances of overcoming symptoms (odds ratio [OR] 1.05; 95% confidence interval (95%CI) 1.01-1.09; p = 0.019). The occurrence of breathlessness within the first ten days (OR 7.89; 95%CI 1.87-41.43; p = 0.008), an initial Ct value under 30 (OR 3.36; 95%CI 1.22-9.94; p = 0.022) as well as the occurrence of anosmia or ageusia within the first ten days (OR 3.01; 95%CI 1.10-8.84; p = 0.037) showed a statistically significant association with increased odds of illness duration over 90 days. CONCLUSION: About half of the HEs suffered from long lasting symptoms over 90 days after almost entirely mild acute COVID-19. Predictive factors could possibly be used for early treatment to prevent development of long-term symptoms after COVID-19 in future.

Emergence and control of linezolid-resistant Staphylococcus epidermidis in an ICU of a German hospital.

Objectives: To investigate an outbreak of linezolid-resistant Staphylococcus epidermidis (LRSE) in an interdisciplinary ICU, linezolid consumption and infection control measures taken. Methods: Routine surveillance of nosocomial infections revealed colonization and infection with LRSE affecting 14 patients during a 15 month period. LRSE isolates were analysed with respect to their clonal relatedness, antimicrobial susceptibility, the presence of cfr and/or mutations in the 23S rRNA, rplC, rplD and rplV genes. cfr plasmids were characterized by Illumina sequencing. Medical records were reviewed and antibiotic consumption was determined. Results: Molecular typing identified the presence of three different LRSE clusters: PFGE type I/ST168 (n = 5), PFGE type II/ST5 (n = 10) and PFGE type III/ST2 (n = 1). Ten strains harboured the cfr gene; we also detected mutations in the respective ribosomal protein genes. WGS revealed an almost identical 39 kb cfr plasmid obtained from strains of different genetic background (ST2, ST5, ST168) that shows high similarity to the recently published LRSE plasmid p12-02300. Due to an increase in the number of patients treated for infections with MRSA, a significant increase in linezolid usage was noted from January to July 2014 (from 5.55 to 20.41 DDDs/100 patient-days). Conclusions: Here, we report the molecular epidemiology of LRSE in an ICU. Our results suggest the selection of resistant mutants under linezolid treatment as well as the spread of cfr-carrying plasmids. The reduction of linezolid usage and the strengthening of contact precautions proved to be effective infection control measures.

Fostering Flexibility in the New World of Work: A Model of Time-Spatial Job Crafting.

In today's "new world of work," knowledge workers are often given considerable flexibility regarding where and when to work (i.e., time-spatial flexibility) and this has become a popular approach to redesigning work. Whilst the adoption of such practices is mainly considered a top-down approach to work design, we argue that successful utilization of time-spatial flexibility requires proactivity on the part of the employee in the form of time-spatial job crafting. Previous research has demonstrated that time-spatial flexibility can have both positive and negative effects on well-being, performance, and work-life balance; yet remains mute about the underlying reasons for this and how employees can handle the given flexibility. Drawing on research from work design, we posit that in order for employees to stay well and productive in this context, they need to engage in time-spatial job crafting (i.e., a context-specific form of job crafting that entails reflection on time and place), which can be considered a future work skill. We propose a theoretical model of time-spatial job crafting in which we discuss its components, shed light on its antecedents, and explain how time-spatial job crafting is related to positive work outcomes through a time/spatial-demands fit.