Optimized infection control practices augment the robust protective effect of vaccination for ESRD patients during a hemodialysis facility SARS-CoV-2 outbreak

  1. Megan E. Meller
  2. Bridget L. Pfaff
  3. Andrew J. Borgert
  4. Craig S. Richmond
  5. Deena M. Athas
  6. Paraic A. Kenny
  7. Arick P. Sabin

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Abstract

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  1. Version published to 10.1016/j.ajic.2022.06.025
  2. ScreenIT

    SciScore for 10.1101/2022.03.18.22272356: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    EthicsIRB: Ethical and institutional approval: Specimens were analyzed under a protocol approved by the Gundersen Health System Institutional Review Board (#2-20-03-008; PI: Kenny) to perform next-generation sequencing on remnant specimens after completion of diagnostic testing.
    Sex as a biological variablenot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    All statistical analysis was performed using the SAS software suite, version 9.4 (SAS Foundation, Cary NC).
    SAS
    suggested: (SASqPCR, RRID:SCR_003056)

    Results from OddPub: Thank you for sharing your data.

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Moreover, intra-facility mitigation efforts would have been insufficient in face of inadequacies in infection control practices taking place during transportation, commingling of patients outside the facility, vaccine uptake among persons in the ESRD patients’ close orbit, and practical limitations imposed on facilities unable to meet all elements of existing guidelines (such as cohorting, segregating, and distancing dialysis patients in markedly resource-limited settings). With no additional cases identified after the first round of testing, our facility demonstrated the effectiveness of a pod with a separate entrance to control the spread of this strain within the facility (Table 3E). All staff entering the area used full respiratory protection with a PAPR or N95 mask. The team also reengaged the facilities team to assess facility air exchange. Collectively, these variables should be reviewed on an ongoing basis during facility quality assurance and performance improvement meetings. Individual behaviors outside the facility during shared transport (by either patients or staff) or pre-/post-treatment socializing were likely of higher prospective risk compared to those risks existing within the facility, and presumably contributed to the size of the cluster, albeit largely outside the control of facility management. This outbreak occurred several months after widespread availability of SARS-CoV-2 vaccines, by which time rates of new vaccinations had substantially slowed. Evid...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  3. Version published to 10.1101/2022.03.18.22272356 on medRxiv