Viney K A, Kehoe P J, Doyle B, Sheppeard V, Roberts-Witteveen A R, Semirli H, McPhie K A, Dwyer D E, McAnulty J M
Public Health Training and Development Branch, NSW Department of Health, North Sydney, NSW, Australia.
Epidemiol Infect. 2008 Sep;136(9):1197-206. doi: 10.1017/S0950268807009843. Epub 2007 Nov 30.
The objective of the study was to identify the extent and cause of an outbreak of epidemic keratoconjunctivitis (EKC). The study design was active case finding and a case-control study of clinic patients who developed symptoms of EKC between 31 December 2005 and 31 March 2006. The main outcome measures were clinical procedures carried out and clinicians seen during clinic visit. Significantly more cases than controls had tonometry with instillation of anaesthetic drops (OR 16.5, 95% CI 3.9-145.1, P<0.01), optical coherence tomography (OR 4.7, 95% CI 1.2-21.9, P=0.01), or instillation of dilating drops by an orthoptist (OR 2.3, 95% CI 1.1-4.7, P=0.01). Significantly more cases than controls were seen by one orthoptist (OR 21.8, 95% CI 8.2-60.0, P<0.01). Transmission of EKC within the clinic was probably due to contamination of either or both the anaesthetic drops and the tonometer head in the room used by an orthoptist. A comprehensive suite of strategies is required to prevent healthcare-associated EKC.
该研究的目的是确定流行性角结膜炎（EKC）暴发的程度和原因。研究设计为主动病例发现以及对2005年12月31日至2006年3月31日期间出现EKC症状的门诊患者进行病例对照研究。主要结局指标为门诊就诊期间所进行的临床操作以及所看的临床医生。与对照组相比，显著更多的病例接受了滴入麻醉滴眼液后的眼压测量（比值比[OR]16.5，95%置信区间[CI]3.9 - 145.1，P<0.01）、光学相干断层扫描（OR 4.7，95% CI 1.2 - 21.9，P = 0.01）或由斜视矫正师滴入散瞳滴眼液（OR 2.3，95% CI 1.1 - 4.7，P = 0.01）。与对照组相比，显著更多的病例由一名斜视矫正师看过（OR 21.8，95% CI 8.2 - 60.0，P<0.01）。门诊内EKC的传播可能是由于斜视矫正师使用的房间内麻醉滴眼液和眼压计头部其中之一或两者受到污染。需要一套全面的策略来预防医疗保健相关的EKC。
