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Epidemic adenoviral keratoconjunctivitis possibly related to ophthalmological procedures in a neonatal intensive care unit: lessons from an outbreak.
MedLine Citation:
PMID:  23171206     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Purpose: Epidemic adenoviral keratoconjunctivitis can spread rapidly among preterm infants who frequently undergo ophthalmological examination. Here we present our experience on a nosocomial outbreak that affected 8 nursery staff members and 26 premature infants. We focus on the presentation and progress of the outbreak, the diagnosis of the disease and the measures taken for its control. Methods: Data were collected from patients' files and records of the infection control team. Conjunctival swabs were collected to perform direct fluorescent assay (DFA) and viral culture. Diagnosis was made according to clinical evidence and/or detection of the virus. Statistical analysis was performed using SPSS 15.0 statistical software. Results: Infection was introduced to our unit after a laser photocoagulation procedure of a 28-week gestational infant and circulated rapidly within the unit due to direct transmission through contaminated medical equipment, fomites and hands of nursery staff members. Neither the patients, nor the nursery staff members developed systemic symptoms. While DFA tests were positive in seven infants, culture positivity could be demonstrated in only three infants. Contact and droplet precautions were implemented with the recommendation of the infection control team. No recurrence occurred after definition of the last case on the 32nd day. Conclusion: Ophthalmologic procedures continue to be a potential source of adenovirus outbreaks. However, negligence of contact measures during routine daily nursing care seems to be a more important contributing factor for rapid spread. Strict adherence to appropriate aseptic procedures is required to prevent this potentially hazardous infection in preterm infants.
Authors:
Sebnem Calkavur; Ozgur Olukman; Arif Taylan Ozturk; Fatma Kaya Kilic; Gamze Gulfidan; Ilker Devrim; Rana Malatyali; Yeliz Oruc; Fusun Atlihan
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Ophthalmic epidemiology     Volume:  19     ISSN:  1744-5086     ISO Abbreviation:  Ophthalmic Epidemiol     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-11-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9435674     Medline TA:  Ophthalmic Epidemiol     Country:  England    
Other Details:
Languages:  eng     Pagination:  371-9     Citation Subset:  IM    
Affiliation:
Neonatal Intensive Care Unit, Dr. Behcet Uz Children's Hospital , Izmir , Turkey.
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