title: Nosocomial adenovirus infection: molecular epidemiology of an outbreak.
abstract: Nosocomial transmission of adenovirus type 3 associated with fatalities in infants has not been frequently reported. This report describes the nosocomial spread of adenovirus types 2 and 3 among infants with bronchopulmonary dysplasia in a chronic (transitional) care facility. The index case developed pneumonia with a clinical deterioration in respiratory status 8 days after admission. Within the next 10 to 30 days 9 other infants and 2 health care personnel became ill with respiratory symptoms. Three of these 10 infants had progressive respiratory failure and 2 of them died. All of these infants had underlying chronic lung disease of bronchopulmonary dysplasia. The overall attack rate was 30% (10 of 33). Further spread of adenovirus was prevented by using barrier precautions and masks while performing tracheostomy care. Adenovirus isolates were serotyped as Ad3 in 4 patients and 1 staff member, as Ad2 in 3 patients, and as a combination of Ad2 and Ad3 in 1 patient. Two fatalities were associated with Ad3 infection. Three isolates from 2 patients and 1 staff member were not available for typing. Restriction endonuclease analysis was performed on all of these isolates of Ad3 and Ad2. There was no genetic heterogeneity in the isolates, suggesting a common source.
authors.affiliation: Department of Infectious Diseases and Epidemiology, Children's National Medical Center, George Washington University School of Medicine and Health Sciences, Washington, DC 20010.
authors.forename: N
authors.initials: N
authors.lastname: Singh-Naz
authors.forename: M
authors.initials: M
authors.lastname: Brown
authors.forename: M
authors.initials: M
authors.lastname: Ganeshananthan
mesh_terms: D000258:Adenovirus Infections, Human / Q000382:microbiology* / Q000401:mortality / Q000635:transmission; D000260:Adenoviruses, Human / Q000235:genetics*; D000328:Adult; D003428:Cross Infection / Q000382:microbiology* / Q000401:mortality; D004279:DNA, Viral / Q000235:genetics*; D006801:Humans; D007223:Infant; D017758:Infectious Disease Transmission, Patient-to-Professional; D017720:Molecular Epidemiology; D015183:Restriction Mapping; D012703:Serotyping
chemical_list: D004279:DNA, Viral