Fujiwara Osamutaro, Mitamura Yoshinori, Tagawa Hiroshi, Ohba Masahiro, Hashimoto Masato, Suzuki Yasuo, Konno Shinsuke, Sato Akihiko, Sato Hiroko, Takaya Masao, Tashimo Asako, Shizukawa Noriko, Yakuwa Nozomi, Kawaguchi Satoshi, Shimizu Miho, Nagai Shinji, Inatomi Shuichiro, Miyanishi Kiyoe, Ito Hiroki, Saito Yoshiyuki, Nishizaka Kimitoshi, Hatakeyama Rie, Matuda Taisuke, Ohtsuka Kenji
Department of Ophthalmology, Sapporo Medical University, S-1, W-16, Chuo-ku, Sapporo 060-8543, Japan.
Nippon Ganka Gakkai Zasshi. 2003 Jul;107(7):388-92.
To evaluate the clinical features of nosocomial epidemic keratoconjunctivitis(EKC) occurring in the ophthalmology ward of Sapporo Medical University Hospital and to devise preventive measures for it.
We studied the symptoms and clinical course of 2 patients who had EKC and 16 patients who had EKC caused by nosocomial infections in our hospital. We attempted to detect adenovirus antigen and viral DNA from conjunctival swabs and also to isolate the virus.
The clinical symptoms of EKC were conjunctival hyperemia in 18 patients(100%), conjunctival follicles in 11 patients (61.1%), discharge in 8 patients(44.4%), superficial punctate keratopathy in 7 patients(38.9%), swelling of the eyelids in 3 patients(16.7%), and fever in 3 patients(16.7%). 72% were positive for Adeno-check. Adenovirus type 4 was isolated from the conjunctival swabs. We considered that the route of hospital infection was infection from the doctor's hands, from eye drops, and from contact lenses. We disclosed that nosocomical EKC had occurred in our hospital. The hospital infection was eliminated by closing the ophthalmology ward and sterilizing instruments and washing hands.
The delay of proper measures increased the risk of nosocomical infection. We recognized the importance of careful observation of patients and immediate preventive efforts in nosocomical infection.
评估札幌医科大学医院眼科病房发生的医院内流行性角结膜炎（EKC）的临床特征，并制定预防措施。
我们研究了2例EKC患者以及本院16例因医院感染导致EKC患者的症状和临床病程。我们试图从结膜拭子中检测腺病毒抗原和病毒DNA，并分离病毒。
EKC的临床症状为18例患者（100%）结膜充血，11例患者（61.1%）结膜滤泡，8例患者（44.4%）有分泌物，7例患者（38.9%）有浅层点状角膜炎，3例患者（16.7%）眼睑肿胀，3例患者（16.7%）发热。Adeno-check检测72%呈阳性。从结膜拭子中分离出4型腺病毒。我们认为医院感染途径是医生手部感染、眼药水感染和隐形眼镜感染。我们披露本院发生了医院内EKC。通过关闭眼科病房、器械消毒和洗手消除了医院感染。
采取适当措施的延迟增加了医院感染的风险。我们认识到在医院感染中仔细观察患者和立即采取预防措施的重要性。
