An outbreak of epidemic keratoconjunctivitis in a pediatric unit due to adenovirus type 8
An outbreak of epidemic keratoconjunctivitis in a pediatric unit due to adenovirus type 8
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DOI：
10.1086/502247
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发表时间：
2003-07-01
影响因子：
4.5
通讯作者：
Wendt, C
中科院分区：
文献类型：
--
作者：
Chaberny, IF;Schnitzler, P;Wendt, C
目的：调查和控制发生在新生儿重症监护病房（NICU）的流行性角结膜炎（EKC）的暴发，并确定新生儿EKC的特异性体征。设计：暴发调查和病例对照研究。地点：德国海德堡一所拥有1,600张床位的大学医院的NICU。病例患者定义为通过ELISA或PCR从结膜拭子中检测到腺病毒抗原或具有结膜炎临床体征的个体。1998年10月至11月期间，12名新生儿重症监护病房的EKC患者与11名细菌性结膜炎患者进行了比较。干预：控制措施包括将接触隔离的患者聚集在一起，使用手套和长袍进行患者护理，并使用手擦和具有杀病毒活性的消毒剂。根据我们的病例定义，13名患者，6名医护人员和11名患者亲属患有EKC。与对照组患者相比，病例组患者更容易出现泪肿（P <0.001）、眼睛发红（P = 0.004）和流泪（P = 0.037），累及双眼（P = 0.002）。眼科医生的既往检查是EKC的重要危险因素（P = .004）。为了诊断或治疗视网膜病变，早产儿由附近眼科护理中心的眼科医生进行检查，该中心正在进行EKC爆发。没有新的病例被诊断超过10天后实施的控制measurement.CONCLUSION：在新生儿，泪肿，眼睛发红，流泪，双眼应引起怀疑EKC。接触过已知EKC病例的眼科医生应在接触新生儿前使用具有杀病毒活性的防腐剂和消毒剂，或避免检查新生儿。
OBJECTIVES: To investigate and control an outbreak of epidemic keratoconjunctivitis (EKC) occurring in a neonatal intensive care unit (NICU) and to determine signs specific for EKC in newborns.DESIGN: Outbreak investigation and case-control study.SETTING: NICU of a 1,600-bed university hospital in Heidelberg, Germany.PATIENTS: Case-patients were defined as individuals who had adenoviral antigen detected by ELISA or by PCR from conjunctival swabs or who had clinical signs of conjunctivitis. Twelve newborns from the NICU who had EKC between October and November 1998 were compared with 11 who had bacterial conjunctivitis.INTERVENTION: Control measures included cohorting patients in contact isolation, using gloves and gowns for patient care, and using a hand rub and disinfectants with virucidal activity.RESULTS: Thirteen patients, 6 healthcare workers, and 11 relatives of the patients had EKC, according to our case definition. Case-patients were more likely than control-patients to develop lacrimal swelling (P < .001), eye redness (P = .004), and lacrimation (P = .037) involving both eyes (P = .002). Prior examination by an ophthalmologist was a significant risk factor for EKC (P = .004). For diagnosis or treatment of retinopathy, premature newborns were seen by an ophthalmologist from a nearby eye care center where an EKC outbreak was ongoing. No new cases were diagnosed more than 10 days after the implementation of control measures.CONCLUSION: In newborns, lacrimal swelling, eye redness, and lacrimation in both eyes should evoke suspicion of EKC. Ophthalmologists who have had contact with known EKC cases should use antiseptics and disinfectants with virucidal activity before contact with newborns or abstain from examining newborns.