RESUMEN
We characterized serology following a nursing home outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) where residents were serially tested by reverse-transcription polymerase chain reaction (RT-PCR) and positive residents were cohorted. When tested 46-76 days later, 24 of 26 RT-PCR-positive residents were seropositive; none of the 124 RT-PCR-negative residents had confirmed seropositivity, supporting serial SARS-CoV-2 RT-PCR testing and cohorting in nursing homes.
Asunto(s)
COVID-19 , SARS-CoV-2 , Brotes de Enfermedades , Humanos , Reacción en Cadena de la Polimerasa , Instituciones de Cuidados Especializados de EnfermeríaRESUMEN
On March 28, 2020, two residents of a long-term care skilled nursing facility (SNF) at the Veterans Affairs Greater Los Angeles Healthcare System (VAGLAHS) had positive test results for SARS-CoV-2, the cause of coronavirus disease 2019 (COVID-19), by reverse transcription-polymerase chain reaction (RT-PCR) testing of nasopharyngeal specimens collected on March 26 and March 27. During March 29-April 23, all SNF residents, regardless of symptoms, underwent serial (approximately weekly) nasopharyngeal SARS-CoV-2 RT-PCR testing, and positive results were communicated to the county health department. All SNF clinical and nonclinical staff members were also screened for SARS-CoV-2 by RT-PCR during March 29-April 10. Nineteen of 99 (19%) residents and eight of 136 (6%) staff members had positive test results for SARS-CoV-2 during March 28-April 10; no further resident cases were identified on subsequent testing on April 13, April 22, and April 23. Fourteen of the 19 residents with COVID-19 were asymptomatic at the time of testing. Among these residents, eight developed symptoms 1-5 days after specimen collection and were later classified as presymptomatic; one of these patients died. This report describes an outbreak of COVID-19 in an SNF, with case identification accomplished by implementing several rounds of RT-PCR testing, permitting rapid isolation of both symptomatic and asymptomatic residents with COVID-19. The outbreak was successfully contained following implementation of this strategy.
Asunto(s)
Betacoronavirus/aislamiento & purificación , Técnicas de Laboratorio Clínico/métodos , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/prevención & control , Brotes de Enfermedades/prevención & control , Pandemias/prevención & control , Neumonía Viral/diagnóstico , Neumonía Viral/prevención & control , Instituciones de Cuidados Especializados de Enfermería , Servicios de Salud para Veteranos , Anciano , Anciano de 80 o más Años , COVID-19 , Prueba de COVID-19 , Infecciones por Coronavirus/epidemiología , Femenino , Humanos , Cuidados a Largo Plazo , Los Angeles/epidemiología , Masculino , Neumonía Viral/epidemiología , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , SARS-CoV-2 , Veteranos/estadística & datos numéricosRESUMEN
Fungal prosthetic valve endocarditis (PVE) is rare and carries a high mortality rate. While uncommon, fungal endocarditis in transcatheter aortic valves has been reported. We present a unique case of Candida parapsilosis fungal PVE in a patient with a transcatheter pulmonary valve replacement.