title: Nosocomial outbreak of epidemic keratoconjunctivitis accompanying environmental contamination with adenoviruses.
abstract: An outbreak of acute keratoconjunctivitis involving 27 patients occurred in the Department of Ophthalmology, Kurume University Hospital. Adenoviral DNA was detected in four inpatients, one outpatient and one healthcare worker. Sequence-based typing of adenoviral DNA indicated serotype 3 from one inpatient, the rest being serotype 37. At a later stage of the outbreak adenoviral DNA types 37 and/or 3 were also detected from almost all environmental instruments and commonly used eye drops, despite thorough disinfection of the environment and enforcement of various infection control measures. The detection rate of adenoviral DNA in environmental swabs was 81%. A further second disinfection of the environment reduced the detection rate of adenoviral DNA to 38%. The outbreak ceased after closing the ophthalmology ward and outpatient consulting room, accompanied by enhanced cleaning of environmental instruments and the introduction of disposable eye drops for individual patients.
authors.affiliation: Division of Infectious Diseases, Department of Infectious Medicine, Kurume University School of Medicine, Kurume, Japan. nhamada@med.kurume-u.ac.jp
authors.forename: N
authors.initials: N
authors.lastname: Hamada
authors.forename: K
authors.initials: K
authors.lastname: Gotoh
authors.forename: K
authors.initials: K
authors.lastname: Hara
authors.forename: J
authors.initials: J
authors.lastname: Iwahashi
authors.forename: Y
authors.initials: Y
authors.lastname: Imamura
authors.forename: S
authors.initials: S
authors.lastname: Nakamura
authors.forename: C
authors.initials: C
authors.lastname: Taguchi
authors.forename: M
authors.initials: M
authors.lastname: Sugita
authors.forename: R
authors.initials: R
authors.lastname: Yamakawa
authors.forename: Y
authors.initials: Y
authors.lastname: Etoh
authors.forename: N
authors.initials: N
authors.lastname: Sera
authors.forename: T
authors.initials: T
authors.lastname: Ishibashi
authors.forename: K
authors.initials: K
authors.lastname: Chijiwa
authors.forename: H
authors.initials: H
authors.lastname: Watanabe
mesh_terms: D000256:Adenoviridae / Q000145:classification / Q000235:genetics / Q000472:pathogenicity; D000257:Adenoviridae Infections / Q000453:epidemiology* / Q000235:genetics; D003428:Cross Infection / Q000453:epidemiology / Q000821:virology*; D004196:Disease Outbreaks; D050456:Fomites / Q000821:virology; D006785:Hospitals, University; D006801:Humans; D007564:Japan / Q000453:epidemiology; D007637:Keratoconjunctivitis / Q000453:epidemiology / Q000821:virology*; D009883:Ophthalmic Solutions / Q000009:adverse effects*
chemical_list: D009883:Ophthalmic Solutions