Warren D, Nelson K E, Farrar J A, Hurwitz E, Hierholzer J, Ford E, Anderson L J
Section of Infection Control, University of Illinois Hospital, Chicago.
J Infect Dis. 1989 Dec;160(6):938-43. doi: 10.1093/infdis/160.6.938.
Between July 1985 and January 1986, 401 patients with adenovirus epidemic keratoconjunctivitis (EKC) were seen at the Illinois Eye and Ear Infirmary. Of the cases, 110 (27%) were nosocomial; the other 291 patients had community acquired infection. The highest attack rates of EKC occurred in patients attending specialty clinics; the overall attack rate among clinic patients was 4.7/1,000 clinic visits. All nosocomial cases were caused by adenovirus type 8; community acquired cases were a mixture of adenovirus types 8 and 37. Adenoviruses were isolated from conjunctival cultures up to 14 d after the onset of clinical illness. Initial efforts to prevent nosocomial transmission were unsuccessful. However, when a plan to triage all patients on entry to the infirmary and to sort patients and personnel caring for infected patients into cohorts was implemented, nosocomial transmission of EKC was promptly and effectively halted, despite the continuation of the community epidemic for another 4 mo. This outbreak clearly demonstrates the efficacy of rigorous infection control in preventing nosocomial transmission of adenovirus EKC.
1985年7月至1986年1月期间，伊利诺伊眼耳医院共接诊了401例腺病毒流行性角结膜炎（EKC）患者。其中110例（27%）为医院感染病例；其余291例患者为社区获得性感染。EKC的最高发病率出现在专科门诊患者中；门诊患者的总体发病率为每1000次门诊就诊4.7例。所有医院感染病例均由8型腺病毒引起；社区获得性病例为8型和37型腺病毒的混合感染。在临床疾病发作后长达14天的时间里，均可从结膜培养物中分离出腺病毒。最初预防医院内传播的努力未获成功。然而，当实施一项计划，即在患者入院时对所有患者进行分诊，并将感染患者及其护理人员分类成组时，尽管社区疫情又持续了4个月，但EKC的医院内传播迅速且有效地得到了遏制。这次疫情清楚地证明了严格的感染控制在预防腺病毒EKC医院内传播方面的有效性。
