Nosocomial outbreak of epidemic keratoconjunctivitis accompanying environmental contamination with adenoviruses

• Published in: The Journal of hospital infection Vol. 68; no. 3; pp. 262 - 268
• Main Authors: Hamada, N, Gotoh, K, Hara, K, Iwahashi, J, Imamura, Y, Nakamura, S, Taguchi, C, Sugita, M, Yamakawa, R, Etoh, Y, Sera, N, Ishibashi, T, Chijiwa, K, Watanabe, H
• Format: Journal Article
• Language: English
• Published: Kent Elsevier Ltd 01.03.2008; Elsevier
• Subjects: Adenoviridae - classification; Adenoviridae - genetics; Adenoviridae - pathogenicity; Adenoviridae Infections - epidemiology; Adenoviridae Infections - genetics; Adenovirus; Biological and medical sciences; Cross Infection - epidemiology; Cross Infection - virology; Disease Outbreaks; Diseases of cornea, anterior segment and sclera; Eye drops; Fomites - virology; General aspects; Hospitals, University; Human infectious diseases. Experimental studies and models; Human viral diseases; Humans; Infectious Disease; Infectious diseases; Japan - epidemiology; Keratoconjunctivitis; Keratoconjunctivitis - epidemiology; Keratoconjunctivitis - virology; Medical sciences; Nosocomial outbreak; Ophthalmic Solutions - adverse effects; Ophthalmology; Viral diseases; Viral diseases with cutaneous or mucosal lesions and viral diseases of the eye; Japan; Keratoconjunctivitis; Eye drops; Nosocomial outbreak; Adenovirus; Epidemic; Nosocomial infection; Adenoviridae; Keratopathy; Conjunctiva disease; Contamination; Infection; Virus; Eye; Eye disease; Viral disease; Human adenovirus; Mastadenovirus; Epidemic keratoconjunctivitis; Anterior segment disease; Public health
• ISSN: 0195-6701; 1532-2939
• DOI: 10.1016/j.jhin.2007.12.012

Summary An outbreak of acute keratoconjunctivitis involving 27 patients occurred in the Department of Ophthalmology, Kurume University Hospital. Adenoviral DNA was detected in four inpatients, one outpatient and one healthcare worker. Sequence-based typing of adenoviral DNA indicated serotype 3 from one inpatient, the rest being serotype 37. At a later stage of the outbreak adenoviral DNA types 37 and/or 3 were also detected from almost all environmental instruments and commonly used eye drops, despite thorough disinfection of the environment and enforcement of various infection control measures. The detection rate of adenoviral DNA in environmental swabs was 81%. A further second disinfection of the environment reduced the detection rate of adenoviral DNA to 38%. The outbreak ceased after closing the ophthalmology ward and outpatient consulting room, accompanied by enhanced cleaning of environmental instruments and the introduction of disposable eye drops for individual patients.