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Objective: To examine the appropriateness of the decision to quarantine healthcare workers (HCW’s) exposed to COVID-19. Design: Retrospective cohort study Setting: A tertiary medical center in Israel Participants: HCW’s exposed to a co-worker infected with COVID-19. Methods: Quarantined and non-quarantined HCW’s were followed up for up to one month following exposure and their COVID-19 status determined. The validity of the decision to quarantine was assessed. Results: A total of 2,595 HCW’s exposed to 419 confirmed index cases were studied. Of the contact cases, 752 HCW’s were quarantined and 1,843 HCWs were not. Of those quarantined, 36 became COVID-19 positive (4.7%). Among those who were not quarantined, only 13 (0.7%) became COVID-19 positive, translated to a sensitivity of 73.5% and a specificity of 71.9% for the decision to quarantine (positive and negative predictive values: 4.7% and 99/3, respectively). Controlling for confounders, the decision to quarantine the HCW by the Israeli Ministry of Health guidelines was associated with a significant risk of becoming COVID-19 positive (RR= 3.83, 95% CI: 1.98-7.36, P=0.001). If a non-selective policy was used, 11,700 working days would have been lost (902 working days lost per one positive case). Conclusion: Efficient and tight system of HCW contact investigations served its purpose. The study was based on HCWs’ reports and reported adherence to safety regulations and its findings are relevant to the massive waves of the Alpha variant of COVID-19 yet still they demonstrate an effective way of handling risk while not causing damage due to arbitrary risk control measures.

BackgroundPreterm infants are at high risk for extended spectrum β-lactamase producing Enterobacteriaceae (ESBL-E) sepsis and neonatal intensive care unit (NICU) outbreaks. There is no consensus regarding surveillance of pregnant women for ESBL-E colonization. However, neonatal screening is accepted in order to prevent NICU’s transmissions by contact isolation. We hypothesized that a significant proportion of ESBL-E colonized infants in our NICU were due to mother-to-child transmission. The aim of this study was to molecularly identify pairs of mothers and offspring ESBL-E colonization.MethodsThe Soroka University Medical Center serves the entire population of southern Israel with an estimated 17,000 deliveries per year. This was a one year analysis from an ongoing, prospective, active rectal ESBL-E colonization surveillance of mothers of premature infants and their offspring. Pairs of mothers and infants colonized with the same bacteria underwent molecular identification by pulse-field gel electrophoresis (PFGE).ResultsBetween January 2015 and February 2016, 311(76%) out of 407 mothers and all 477(100%) infants were screened for ESBL-E colonization; carriage rates were 21.5% and 14.9%, respectively. Four (5.6%) carrier infants developed late onset sepsis and 2 (2.8%) died. Mothers of 47% (28) ESBL-E carrier infants were colonized at delivery; comparison of the characteristics between colonized infants of positively and negatively screened mothers is presented in Table 1. Twenty-three (34.3%) colonized mothers delivered 25 infants who were found to be colonized with the same bacterial strain according to species’ identification and antibiogram. A subgroup of 10 mother-infant dyads underwent PFGE and 70% shared identical molecular fingerprint patterns. No similarities were found between isolates recovered from unrelated neonates and mothers.ConclusionHigh ESBL-E carriage rates in mothers and NICU’S infants, in our region, with a non-negligible maternal-neonatal ESBL-E colonization transmission illuminates the importance of maternal ESBL colonization surveillance and further consideration regarding infectious control preventive measurements.Disclosures All authors: No reported disclosures.