The possibility of human adenovirus detection from the conjunctiva in asymptomatic cases during nosocomial infection
The possibility of human adenovirus detection from the conjunctiva in asymptomatic cases during nosocomial infection
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DOI：
10.1097/ico.0b013e31816060bb
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发表时间：
2008-06-01
期刊：
影响因子：
2.8
通讯作者：
Suzutani, Tatsuo
中科院分区：
文献类型：
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作者：
Kaneko, Hisatoshi;Maruko, Khiro;Suzutani, Tatsuo
目的：为预防医院内腺病毒性结膜炎的爆发，必须进行适当的传播控制管理。我们收集结膜样本，无症状的住院患者和眼科医生在眼科病房，并试图检测人类腺病毒（HAdV）病原体感染control.Methods：一名住院患者被诊断为腺病毒结膜炎的基础上，典型的，急性的，严重的症状和病毒学检测使用免疫层析（IC）试剂盒。为了调查医院感染，对17名无明显腺病毒结膜炎症状的住院患者和1名眼科医生的结膜拭子进行采样，并使用IC试剂盒、病毒分离、巢式聚合酶链反应（PCR）和实时PCR分析HAdV病原体。用IC试剂盒和巢式PCR方法分别从18份医院调查标本中检测到1份和8份HAdV抗原和DNA。此外，在细胞培养物中仅从1个抗原阳性样品中分离出感染性HAdV。所有PCR阳性样品具有相同的部分六邻体基因的核苷酸序列，并通过系统发育分析确定为HAdV 37型。没有住院患者表现出任何典型的腺病毒结膜炎的症状，但术后反应引起的轻微结膜感染和/或轻度结膜炎，不像HAdV感染观察。在2个月的随访中，没有人出现典型的腺病毒性结膜炎。结论：腺病毒性结膜炎的临床病程从不明显的感染到严重的结膜炎不等。轻度或不明显的HAdV结膜感染在结膜炎暴发期间可能很常见，并且可能在医院获得性腺病毒结膜炎的传播中起作用。
Purpose: To prevent outbreaks of nosocomial adenoviral conjunctivitis, proper management for transmission control must be performed. We collected conjunctival samples from asymptomatic inpatients and an ophthalmologist in an ophthalmology ward and attempted to detect the human adenovirus (HAdV) pathogen for infection control.Methods: One inpatient was diagnosed with adenoviral conjunctivitis on the basis of typical, acute, and severe symptoms and virologic testing by using an immunochromatography (IC) kit. To survey nosocomial infection, conjunctival swabs from 17 other inpatients and 1 ophthalmologist without obvious symptoms of adenoviral conjunctivitis were sampled and analyzed for HAdV pathogens with an IC kit, viral isolation, nested polymerase chain reaction (PCR), and real-time PCR.Results: HAdV antigens and DNA were detected from 1 and 8 of the 18 samples collected for nosocomial survey by IC kit and nested PCR method, respectively. Moreover, infectious HAdV was isolated in the cell culture from only 1 antigen-positive sample. All PCR-positive samples had identical nucleotide sequences of the partial hexon gene and were determined to be HAdV type 37 by phylogenetic analysis. No inpatients tested showed any symptoms of typical adenoviral conjunctivitis, but slight conjunctival infection caused by postoperative reaction and/or mild conjunctivitis that did not resemble HAdV infection was observed. No one developed typical adenoviral conjunctivitis over the 2-month follow-up.Conclusions: The clinical course of adenoviral conjunctivitis varies from inapparent infection to severe conjunctivitis. Mild or inapparent HAdV conjunctival infection could be common during conjunctivitis outbreaks and might play a role in the spread of nosocomial adenoviral conjunctivitis.