Clusters of healthcare-associated SARS-CoV-2 infections in Norwegian hospitals detected by a fully automatic register-based surveillance system.

BACKGROUND: Notifications to the Norwegian Institute of Public Health of outbreaks in Norwegian healthcare institutions are mandatory by law, but under-reporting is suspected due to failure to identify clusters, or because of human or system-based factors. This study aimed to establish and describe a fully automatic, register-based surveillance system to identify clusters of healthcare-associated infections (HAIs) of SARS-CoV-2 in hospitals and compare these with outbreaks notified through the mandated outbreak system Vesuv. METHODS: We used linked data from the emergency preparedness register Beredt C19, based on the Norwegian Patient Registry and the Norwegian Surveillance System for Communicable Diseases. We tested two different algorithms for HAI clusters, described their size and compared them with outbreaks notified through Vesuv. RESULTS: A total of 5033 patients were registered with an indeterminate, probable, or definite HAI. Depending on the algorithm, our system detected 44 or 36 of the 56 officially notified outbreaks. Both algorithms detected more clusters then officially reported (301 and 206, respectively). CONCLUSIONS: It was possible to use existing data sources to establish a fully automatic surveillance system identifying clusters of SARS-CoV-2. Automatic surveillance can improve preparedness through earlier identification of clusters of HAIs, and by lowering the workloads of infection control specialists in hospitals.

[Pyoderma gangrenosum associated with seronegative polyarthritis. Report of a case. Review of the literature (author's transl)]. / Pyoderma gangrenosum associé a une polyarthrite séro-négative. A propos d'un cas. Revue de la littérature.

Pyoderma gangrenosum developed in a 45-year-old caucasian woman who had an 18 year past history of seronegative polyarthritis without any visceral or haematologic associated abnormalities. A literature review revealed only 12 reported cases. Extensive laboratory evaluation failed to detect alterations of the immune functions. The presence of a vasculitis with C3 deposits suggested that levamisole may have played a role in eliciting the lesion. Clofazimine, administered for a period of one month, was a relative failure.