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Five-year trends in adenoviral conjunctivitis in employees of one medical center

Published online by Cambridge University Press:  28 June 2018

Irene C. Kuo  and
Colleen Espinosa
Irene C. Kuo*
Affiliation:
Department of Ophthalmology, The Wilmer Eye Institute, the Johns Hopkins University School of Medicine, Baltimore, Maryland
Colleen Espinosa
Affiliation:
Division of Occupational and Environmental Medicine, The Johns Hopkins Hospital, Baltimore, Maryland
*
Author for correspondence: Irene C. Kuo, MD, The Wilmer Eye Institute, 4924 Campbell Blvd. #100, Baltimore, MD 21236. E-mail: [email protected]
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Abstract

Objective

To describe the 5-year findings after a policy to screen for, diagnose, and isolate medical center employees with adenoviral conjunctivitis was implemented.

Design

Observational report with a retrospective evaluation of a current quality improvement initiative.

Setting

Johns Hopkins Medicine, Baltimore, Maryland.

Participants

Johns Hopkins Medicine employees.

Methods

Data were retrieved from records maintained for this initiative, in which employees with suspected adenoviral conjunctivitis were evaluated in the Occupational Health Clinic and swabbed for polymerase chain reaction (PCR) testing for adenoviral conjunctivitis. Signs, symptoms, work area, diagnoses, and disposition of employees with eye complaints as well as PCR result and adenoviral type were recorded. Five-year data were reviewed.

Results

From 2011 to 2016, of 10,000 full-time equivalent employees, 1,059 employees visited the Occupational Health Clinic with suspicion of adenoviral conjunctivitis. Of these, 104 (10%) were PCR positive for adenovirus. Of these PCR-positive employees, 26 (25%) had the worst clinical presentation, epidemic keratoconjunctivitis (EKC). The Outpatient Pharmacy had the highest number of adenoviral conjunctivitis cases (n=9). The proportion of red-eye employees having PCR-positive adenoviral conjunctivitis increased over 5 years (P<.005, Cochrane-Armitage test for trend) as did the proportion of employees with EKC (P<.05). The proportion of employees with EKC caused by type 37 also increased (P<.05).

Conclusions

Adenoviral conjunctivitis represents 10% of employee cases clinically suspected of this infection. Employees in patient-care areas should be screened even if they have no direct patient contact. Despite increases in the proportions of adenoviral conjunctivitis and of EKC over 5 years, no outbreaks occurred. This policy helps identify incipient EKC outbreaks and guides infection control efforts.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 39 , Issue 9 , September 2018 , pp. 1080 - 1085
Copyright
© 2018 by The Society for Healthcare Epidemiology of America. All rights reserved. 

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Footnotes

Cite this article: Kuo IC, Espinosa C. (2018). Five-year trends in adenoviral conjunctivitis in employees of one medical center. Infection Control & Hospital Epidemiology 2018, 39, 1080–1085. doi: 10.1017/ice.2018.145

References

1. Hamada, N, Gotoh, K, Hara, K, Iwahashi, J, et al. Nosocomial outbreak of epidemic keratoconjunctivitis accompanying environmental contamination with adenoviruses. J Hosp Infect 2008;68:262–268.Google Scholar
2. Hiroi, S, Morikawa, S, Takahashi, K, Komano, J, Kase, T. Molecular epidemiology of human adenoviruses associated with epidemic keratoconjunctivitis in Osaka, Japan, 2001–2010. Jpn J Infect Dis 2013;66:436–438.Google Scholar
3. Vastine, DW, West, CE, Yamashiroya, H, Smith, R, Saxtan, DD, Gieser, DI, Mufson, MA. Simultaneous nosocomial and community outbreak of epidemic keratoconjunctivitis with types 8 and 19 adenovirus. Trans Sect Ophthalmol Am Acad Ophthalmol Otolaryngol 1976;81:826–840.Google Scholar
4. Warren, D, Nelson, KE, Farrar, JA, et al. A large outbreak of epidemic keratoconjunctivitis: problems in controlling nosocomial spread. J Infect Dis 1989;160:938–943.Google Scholar
5. Adenovirus-associated epidemic keratoconjunctivitis outbreaks—four states, 2008–2010. MMWR 2013;62:637–641. Centers for Disease Control and Prevention website. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6232a1.htm. Published 2013. Accessed August 27, 2017.Google Scholar
6. Scharf, S, Holland, S, Werker, DH, Roberts, FJ, Bryce, E. Epidemic keratoconjunctivitis outbreak at a tertiary referral eye care clinic. Am J Infect Control 1998;26:399–405.Google Scholar
7. Piednoir, E, Bureau-Chalot, F, Merle, C, Gotzmanis, A, Wulbout, J, Bajolet, O. Direct costs associated with a nosocomial outbreak of adenoviral conjunctivitis infection in a long-term care instititution. Am J Infect Control 2002;30:407–410.Google Scholar
8. Kuo, IC, Espinosa, C, Forman, M, Pehar, M, Maragakis, LL, Valsamakis, A. Detection and prevalence of adenoviral conjunctivitis among hospital employees using real-time polymerase chain reaction as an infection prevention tool. Infect Control Hosp Epidemiol 2014;35:728–731.Google Scholar
9. Kuo, IC, Espinosa, C, Michael Forman, M, Valsamakis, A. A polymerase chain reaction–based algorithm to detect and prevent transmission of adenoviral conjunctivitis in hospital employees. Am J Ophthalmol 2016;163:38–44.Google Scholar
10. Thompson, PP, Kowalski, RP. A 13-year retrospective review of polymerase chain reaction testing for infectiousagents from ocular samples. Ophthalmology 2011;118:1449–1453.Google Scholar
11. O’Brien, TP, Jeng, BH, McDonald, M, Raizman, MB. Acute conjunctivitis: truth and misconceptions. Curr Med Res Opin 2009;25:1953–1961.Google Scholar
12. Sriwanna, P, Chieochansin, T, Vuthitanachot, C, Vuthitanachot, V, Theamboonlers, A, Poovorawan, Y. Molecular characterization of human adenovirus infection in Thailand, 2009–2012. Virol J 2013;10:193.Google Scholar
13. Berciaud, S, Rayne, F, Kassab, S, et al. Adenovirus infections in Bordeaux University Hospital 2008–2010: clinical and virological features. J Clin Virol 2012;54:302–307.Google Scholar
14. Gray, GC, McCarthy, T, Lebeck, MG, et al. Genotype prevalence and risk factors for severe clinical adenovirus infection, United States 2004–2006. Clin Infect Dis 2007;45:1120–1131.Google Scholar
15. O’Donnell, B, McCruden, EA, Desselberger, U. Molecular epidemiology of adenovirus conjunctivitis in Glasgow 1981–1991. Eye (Lond) 1993;7(Pt 3 Suppl):8–14.Google Scholar
16. Lu, X, Erdman, DD. Molecular typing of human adenoviruses by PCR and sequencing of a partial region of the hexon gene. Arch Virol 2006;151:1587–1602.Google Scholar
17. Killerby, ME, Stuckey, M, Guendel, I, Sakthivel, S, et al. Notes from the field: epidemic keratoconjunctivitis outbreak associated with human adenovirus type 8—US Virgin Islands, June–November 2016. MMWR 2017;66:811–812. Centers for Disease Control and Prevention website. https://www.cdc.gov/mmwr/volumes/66/wr/mm6630a3.htm. Published 2017. Accessed December 4, 2017.Google Scholar
18. Massey, J, Henry, R, Minnich, L, Lamson, D St, George, K. Notes from the field: healthcare-associated outbreak of epidemic keratoconjunctivitis—West Virginia, 2015. MMWR 2016;65;382–383. Centers for Disease Control and Prevention website. https://www.cdc.gov/mmwr/volumes/65/wr/mm6514a5.htm. Published 2016. Accessed December 4, 2017.Google Scholar