Use of real-time semiquantitative PCR data in management of a neonatal intensive care unit adenovirus outbreak
| Autor: | Sandra R. Arnold, Anami Patel, Steven C. Buckingham, Joy Joyner, Mary R. Tanner, John P. DeVincenzo, Nicholas D. Hysmith, Mary Ellen Hoehn, Ramasubbareddy Dhanireddy, Katha Comeaux |
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| Rok vydání: | 2018 |
| Předmět: |
Male
0301 basic medicine Microbiology (medical) Pediatrics medicine.medical_specialty Neonatal intensive care unit Epidemiology 030106 microbiology Real-Time Polymerase Chain Reaction Serogroup Disease Outbreaks Adenovirus Infections Human 03 medical and health sciences Neonatal Screening 0302 clinical medicine Intensive Care Units Neonatal 030225 pediatrics Humans Medicine Infection control Retinopathy of Prematurity Prospective Studies Prospective cohort study Retrospective Studies Cross Infection Infection Control business.industry Transmission (medicine) Adenoviruses Human Infant Newborn Outbreak Retrospective cohort study Retinopathy of prematurity Odds ratio medicine.disease Tennessee Infectious Diseases Female business |
| Zdroj: | Infection Control & Hospital Epidemiology. 39:1074-1079 |
| ISSN: | 1559-6834 0899-823X |
| Popis: | ObjectiveTo describe an adenovirus outbreak in a neonatal intensive care unit (NICU), including the use of qualitative and semiquantitative real-time polymerase chain reaction (qPCR) data to inform the outbreak response.DesignMixed prospective and retrospective observational study.SettingA level IV NICU in the southeastern United States.PatientsTwo adenovirus cases were identified in a NICU. Screening of all inpatients with qPCR on nasopharyngeal specimens revealed 11 additional cases.InterventionsOutbreak response procedures, including enhanced infection control policies, were instituted. Serial qPCR studies were used to screen for new infections among exposed infants and to monitor viral clearance among cases. Changes to retinopathy of prematurity (ROP) exam procedures were made after an association was noted in those patients. At the end of the outbreak, a retrospective review allowed for comparison of clinical factors between the infected and uninfected groups.ResultsThere were no new cases among patients after outbreak identification. One adenovirus-infected patient died; the others recovered their clinical baselines. The ROP exams were associated with an increased risk of infection (odds ratio [OR], 84.6; 95% confidence interval [CI], 4.5–1,601). The duration of the outbreak response was 33 days, and the previously described second wave of cases after the end of the outbreak did not occur. Revisions to infection control policies remained in effect following the outbreak.ConclusionsRetinopathy of prematurity exams are potential mechanisms of adenovirus transmission, and autoclaved or single-use instruments should be used to minimize this risk. Real-time molecular diagnostic and quantification data guided outbreak response procedures, which rapidly contained and fully terminated a NICU adenovirus outbreak. |
| Databáze: | OpenAIRE |
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