신생아 중환자실에서의 아데노바이러스 8형에 의한 유행성 각결막염의 발생
An Outbreak of Epidemic Keratoconjunctivitis by Adenovirus Type 8 in a Neonatal Intensive Care Unit
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Purpose : Epidemic keratoconjunctivitis (EKC) caused by adenovirus is a highly contagious disease, which has been reported as outbreaks involving adults in the community. However, there has been no report on EKC outbreak by adenovirus in a neonatal intensive care unit (NICU) in Korea. Aims of this study were to investigate the EKC outbreak by adenovirus type 8 in NICU and to confirm an effectiveness of polymerase chain reaction (PCR) for diagnosis. Methods : Conjunctival swab or nasopharyngeal aspirate specimens were taken from all patients and tested by viral culture and PCR. Adenovirus serotype was determined by sequencing of PCR product of selected region of hexon gene using the virus isolates or specimens. Results : An outbreak of EKC occurred which was involving 12 preterm infants in the NICU of the Seoul National University Children's Hospital between July 12th and August 1st, 2005. Three hospital staffs and one family member of the neonate were also affected. Adenovirus was detected in 12/12 (100%), 6/11 (54.5%) by PCR and virus culture, respectively. Eleven PCR-positive neonates were identified as serotype 8 by sequencing. The first affected 4 babies have had routine ROP (retinopathy of prematurity) examinations one week ago. While previous outbreaks were sustained for a few months, the event in our unit was controlled without complications in 3 weeks. Conclusion : We analyzed the EKC outbreak by adenovirus type 8 in NICU. Adenovirus serotype was identified by PCR and sequencing with high sensitivity for the first time in Korea, so we suggest this method can be very useful for rapid diagnosis and infection control.
Abstract
Purpose : Epidemic keratoconjunctivitis (EKC) caused by adenovirus is a highly contagious disease, which has been reported as outbreaks involving adults in the community. However, there has been no report on EKC outbreak by adenovirus in a neonatal intensive care unit (NICU) in Korea. Aims of this study were to investigate the EKC outbreak by adenovirus type 8 in NICU and to confirm an effectiveness of polymerase chain reaction (PCR) for diagnosis. Methods : Conjunctival swab or nasopharyngeal aspirate specimens were taken from all patients and tested by viral culture and PCR. Adenovirus serotype was determined by sequencing of PCR product of selected region of hexon gene using the virus isolates or specimens. Results : An outbreak of EKC occurred which was involving 12 preterm infants in the NICU of the Seoul National University Children's Hospital between July 12th and August 1st, 2005. Three hospital staffs and one family member of the neonate were also affected. Adenovirus was detected in 12/12 (100%), 6/11 (54.5%) by PCR and virus culture, respectively. Eleven PCR-positive neonates were identified as serotype 8 by sequencing. The first affected 4 babies have had routine ROP (retinopathy of prematurity) examinations one week ago. While previous outbreaks were sustained for a few months, the event in our unit was controlled without complications in 3 weeks. Conclusion : We analyzed the EKC outbreak by adenovirus type 8 in NICU. Adenovirus serotype was identified by PCR and sequencing with high sensitivity for the first time in Korea, so we suggest this method can be very useful for rapid diagnosis and infection control.
참고문헌 (24)
- Cherry JD, "Textbook of Pediatric Infectious Disease. 5th ed", pp.1843~1863 (2004), Saunders Co
- Ford E, "Epidemiology of epidemic keratoconjunctivitis", Epidemiol Rev, 9, pp.244~261 (1987)
- Lee JA, "Rapid identification of human adenovirus type 3 and 7 from respiratory specimens via multiplex typespecific PCR", J Clin Microbiol, 43, pp.5509~5514 (2005)
- Allard A, "Rapid typing of human adenoviruses by a general PCR combined with restriction endonuclease analysis", J Clin Microbiol, 39, pp.498~505 (2001)
- Sarantis H, "Comprehensive detection and serotyping of human adenoviruses by PCR and sequencing", J Clin Microbiol, 42, pp.3963~3969 (2004)
- Straube RC, "Adenovirus type 7b in a children's hospital", J Infect Dis, 147, pp.814~819 (1983)
- Alpert G, "Outbreak of fatal adenoviral type 7a reapiratory disease in a children's long-term care inpatient facility", Am J Infect Control, 14, pp.188~190 (1986)
- Finn A, "An epidemic of adenovirus 7a infection in a neonatal nursery: course, morbidity, and management", Infect Control Hosp Epidemiol, 9, pp.398~404 (1988)
- Porter JD, "Outbreak of adenoviral infections in a long-term pediatric facility, New Jersey, 1986", 87, 1991, pp.18, 201~210
- Piedra PA, "Description of an adenovirus type 8 outbreak in hospitalized neonates born prematurely", Pediatr Infect Dis J, 11, pp.460~465 (1992)
- Birenbaum E, "Adenovirus type 8 conjunctivitis outbreak in a neonatal intensive care unit", Arch Dis Child, 68, pp.610~611 (1993)
- Gerber SI, "Outbreak of adenovirus genome type 7d2 infection in a pediatric chronic-care facility and tertiary-care hospital", Clin Infect Dis, 32, pp.694~700 (2001)
- Chaberny IE, "An outbreak of epidemic keratoconjunctivitis in a pediatric unit due to adenovirus type 8", Infect Control Hosp Epidemiol, 24, pp.514~519 (2003)
- Percivalle E, "A comparison of methods for detecting adenovirus type 8 keratoconjunctivitis during a nosocomial outbreak in a neonatal intensive care unit", J Clin Virol, 28, pp.257~264 (2003)
- Faden H, "Outbreak of adenovirus type 30 in a neonatal intensive care unit", J Pediatr, 146, pp.523~527 (2005)
- Asencio-Durán M, "Nosocomial outbreak of epidemic keratoconjunctivitis in a neonatal intensive care unit", Arch Soc Esp Oftalmol, 82, pp.73~80 (2007)
- Jeong IS, "Outbreak investigation of epidemic keratoconjunctivitis in a neonatal intensive care unit", Korean J Nosocomial Infect Control, 5, pp.99~110 (1999)
- Colón LE, "Keratoconjunctivitis due to adenovirus type 8: report on a large outbreak", Ann Ophthalmol, 23, pp.63~65 (1991)
- Schmitz H, "Worldwide epidemiology of human adenovirus infection", Am J Epidemiol, 117, pp.455~466 (1983)
- Woodman T, "Disinfection of eyelid speculums for retinopathy of prematurity examination", Arch Ophthalmol, 116, pp.1195~1198 (1998)
- Gordon YJ, "Prolonged recovery of desiccated adenoviral serotypes 5, 8 and 19 from plastic and metal surfaces in vitro", Ophthalmology, 100, pp.1835~1939 (1993)
- Montessori V, "Epidemic keratoconjunctivitis outbreak at a tertiary referral eye care clinic", Am J Infect Control, 26, pp.399~405 (1998)
- Landry ML, "Epidemic keratoconjunctivitis. In: Olmstead RN, editor. Infection control and applied epidemiology. St" (1996), Mosby
- Warren D, "A large outbreak of epidemic keratoconjunctivitis: problems in controlling nosocomial spread", J Infect Dis, 160, pp.938~943 (1989)
