Current status of nosocomial COVID-19 cases in delivery facilities in
Japan: Case-control study
Abstract
Objective: To identify the characteristics of and measures taken by
Japanese medical facilities providing maternity services that have
recorded cases of nosocomial infection with SARS-CoV-2, which causes
coronavirus disease 2019 (COVID-19). Design: A nationwide questionnaire
survey: case-control study. Setting: Medical facilities providing
maternity service in Japan. Population: 1,418 medical facilities
providing maternity service (65% of all delivery facilities in Japan).
Methods: A nationwide questionnaire survey about nosocomial COVID-19 was
conducted in July 2020. A case-control study was conducted by including
medical facilities providing maternity service with (Cases) and without
(Control) nosocomial COVID-19. Main outcome measures: Contributed
characteristics and variables associated with nosocomial COVID-19. The
number of treated pregnant women with COVID-19 until June 2020 and cases
of nosocomial COVID-19 in Japan. Results: Seventy-five COVID-19-positive
pregnant women were treated in 48 facilities. Responses from Nosocomial
infection was reported in 4.1% of the facilities. Nine reports
developed a nosocomial infection in the maternity ward or obstetric
department. Variables that contributed to nosocomial COVID-19 were chest
CT on admission (adjusted odds ratio [95% confidence interval],
4.76 [2.44–9.27]), PCR test for SARS-CoV-2 before delivery (2.27
[1.21–4.25]), transfer of pregnant women with fever to another
hospital (0.21 [0.06–0.71]), and private clinics (0.17
[0.05–0.60]). Conclusion: Nosocomial infection is likely to occur
in large hospitals that treat a higher number of patients than private
clinics do. Nosocomial infection can occur even in medical facilities
performing COVID-19 screening tests, such as chest CT and PCR test.