The bacterium Serratia marcescens is an important opportunistic human pathogen that thrives in many environments, can become multidrug resistant, and is often involved in nosocomial outbreaks in neonatal intensive care units (NICU). We evaluated the role of sinks during five suspected S. marcescens outbreaks in a NICU.

Objective:To describe barriers and facilitators to the adoption of recommended infection prevention and control (IPC) practices among healthcare workers (HCWs).Methods:A qualitative research design was used. Individual semistructured interviews with HCWs and observations of clinical practices were conducted from February to May 2018 in 8 care units of 2 large tertiary-care hospitals in Montreal (Québec, Canada).Results:We interviewed 13 managers, 4 nurses, 2 physicians, 3 housekeepers, and 2 medical laboratory technologists. We conducted 7 observations by following IPC nurses (n = 3), nurses (n = 2), or patient attendants (n = 2) in their work routines. Barriers to IPC adoption were related to the context of care, workplace environment issues, and communication issues. The main facilitator of the IPC adoption by HCWs was the “development of an IPC culture or safety culture.” The “IPC culture” relied upon leadership support by managers committed to IPC, shared belief in the importance of IPC measures to limit healthcare-associated infections (HAIs), collaboration and good communication among staff, as well as proactivity and ownership of IPC measures (ie, development of local solutions to reduce HAIs and “working together” toward common goals).Conclusions:Adoption of recommended IPC measures by HCWs is strongly influenced by the “IPC culture.” The IPC culture was not uniform within hospital and differences in IPC culture were identified between care units.

In a tertiary-care, pediatric healthcare center in Québec, Canada, healthcare workers who reported a household exposure to confirmed coronavirus disease 2019 (COVID-19) cases were allowed to work. On repeated testing, 15% became severe acute respiratory coronavirus virus 2 (SARS-CoV-2)–positive by reverse-transcription polymerase chain reaction (RT-PCR), with no nosocomial transmission. Being asymptomatic and receiving a booster dose >7 days prior to exposure was protective against becoming SARS-CoV-2–positive by PCR.

Due to high community transmission of the Omicron variant, healthcare workers (HCWs) have been increasingly reporting household exposures to confirmed COVID19 cases. Quebec (Canada) provincial guidelines required to quarantine these HCWs. Facing the risk of staffing shortages, our hospital decided to allow them to work. Objective: To evaluate the risk for HCWs, who were household contacts, to become positive for COVID19 and evaluate the risk of nosocomial COVID19 transmission. Design: Cohort of consecutive HCWs with a history of household exposure to a confirmed case of COVID19 who contacted OHS at CHU Sainte-Justine, Montreal (QC) Canada between December 20, 2021 and January 17, 2022 for a history of household exposure to COVID19. Exposure: Confirmed case of COVID19 in the household Main outcome and measures: The main outcome was a positive RT-PCR for SARS-CoV-2. Outbreaks and nosocomial cases were identified through daily analysis of COVID-19 cases, by sector and part of the usual Infection Prevention and Control surveillance process. Results: Overall, 237 of 475 (50%) HCWs who declared a known household contact with a confirmed COVID19 case remained negative. Of those who became positive, 196 (82.4%) were positive upon initial testing and were quarantined. Only 42 (15%) of 279 HCWs who were allowed to work became positive, a median of 4 days after the initial test. The absence of symptoms at initial evaluation (OR 3.8, 95% CI 2.5,5.7) and having received a third vaccine dose more than 7 days before (OR 1.88, 95% CI 1.3,2.8) were associated with an increased odds of remaining negative. There was no outbreak among HCWs and no nosocomial transmission to patients from a HCW that was allowed to work, while a known household contact. Conclusion and relevance: Measures taken to protect the health care environment from COVID19 must be cautiously balanced with the risk of staffing shortage. Allowing vaccinated asymptomatic HCWs who are known household contacts of confirmed COVID19 cases to work is likely a safe alternative, when staff shortage is anticipated.