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Utility of post-admission SARS-CoV-2 serial testing in hospitalized patients with cancer

Published online by Cambridge University Press:  03 December 2024

Shauna Usiak*
Affiliation:
Infection Control, Memorial Sloan Kettering Cancer Center, New York, NY, USA
Anoshe Aslam
Affiliation:
Infection Control, Memorial Sloan Kettering Cancer Center, New York, NY, USA
Judy Yan
Affiliation:
Infection Control, Memorial Sloan Kettering Cancer Center, New York, NY, USA
Jerin Madhavappallil
Affiliation:
Infection Control, Memorial Sloan Kettering Cancer Center, New York, NY, USA
Marissa Bokhari
Affiliation:
Infection Control, Memorial Sloan Kettering Cancer Center, New York, NY, USA
Tiffany Romero
Affiliation:
Infection Control, Memorial Sloan Kettering Cancer Center, New York, NY, USA
Tania N. Bubb
Affiliation:
Infection Control, Memorial Sloan Kettering Cancer Center, New York, NY, USA
Rich Kodama
Affiliation:
Infection Control, Memorial Sloan Kettering Cancer Center, New York, NY, USA Infectious Disease Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
Esther Babady
Affiliation:
Clinical Microbiology Service, Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
Mini Kamboj
Affiliation:
Infection Control, Memorial Sloan Kettering Cancer Center, New York, NY, USA Infectious Disease Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA Department of Medicine, Joan and Sanford Weill Medical College of Cornell University, New York, NY, USA
*
Corresponding author: Shauna Usiak; Email: [email protected]

Abstract

Background:

SARS-CoV-2 asymptomatic surveillance testing (AST) is a common strategy to minimize the risk of nosocomial infection in patients and healthcare personnel. In contrast to admission screening, post-admission AST was less widely adopted.

Objective:

This study describes the diagnostic yield of post-admission serial SARS-COV-2 testing in hospitalized patients at a large cancer center with mostly double-occupancy rooms.

Design:

Retrospective cohort study design. Post-admission SARS-CoV-2 tests were examined over a 18 month study period. Positive results were reviewed to determine true hospital-onset infections using a combination criteria of screening all sample cycle threshold (Ct) values >30, results of non-concordant repeat testing, and clinical symptoms.

Results:

Post-admission serial testing of 15,048 hospitalized patients during an 18-month study period at a tertiary care cancer center detected hospital-onset infection in 1.6% (n = 245 patients). Among all hospital-onset positive SARS-CoV-2 RNA tests, 13% were clinically false positive. Most true infections were mild to moderate in severity.

Conclusions:

In summary, post-admission serial testing in a high-risk setting is a low-yield strategy with several unfavorable effects and should no longer be routinely applied.

Type
Original Article
Copyright
© Memorial Sloan Kettering Cancer Center, 2024. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

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