Department of Ophthalmology, The Wilmer Eye Institute, the Johns Hopkins University School of Medicine, Baltimore, Maryland.
Division of Occupational and Environmental Medicine, The Johns Hopkins Hospital, Baltimore, Maryland.
Infect Control Hosp Epidemiol. 2018 Sep;39(9):1080-1085. doi: 10.1017/ice.2018.145. Epub 2018 Jun 28.
To describe the 5-year findings after a policy to screen for, diagnose, and isolate medical center employees with adenoviral conjunctivitis was implemented.
Observational report with a retrospective evaluation of a current quality improvement initiative.
Johns Hopkins Medicine, Baltimore, Maryland.ParticipantsJohns Hopkins Medicine employees.
Data were retrieved from records maintained for this initiative, in which employees with suspected adenoviral conjunctivitis were evaluated in the Occupational Health Clinic and swabbed for polymerase chain reaction (PCR) testing for adenoviral conjunctivitis. Signs, symptoms, work area, diagnoses, and disposition of employees with eye complaints as well as PCR result and adenoviral type were recorded. Five-year data were reviewed.
From 2011 to 2016, of 10,000 full-time equivalent employees, 1,059 employees visited the Occupational Health Clinic with suspicion of adenoviral conjunctivitis. Of these, 104 (10%) were PCR positive for adenovirus. Of these PCR-positive employees, 26 (25%) had the worst clinical presentation, epidemic keratoconjunctivitis (EKC). The Outpatient Pharmacy had the highest number of adenoviral conjunctivitis cases (n=9). The proportion of red-eye employees having PCR-positive adenoviral conjunctivitis increased over 5 years (P<.005, Cochrane-Armitage test for trend) as did the proportion of employees with EKC (P<.05). The proportion of employees with EKC caused by type 37 also increased (P<.05).
Adenoviral conjunctivitis represents 10% of employee cases clinically suspected of this infection. Employees in patient-care areas should be screened even if they have no direct patient contact. Despite increases in the proportions of adenoviral conjunctivitis and of EKC over 5 years, no outbreaks occurred. This policy helps identify incipient EKC outbreaks and guides infection control efforts.
描述实施筛查、诊断和隔离医疗机构员工腺病毒结膜炎的政策 5 年后的发现。
观察性报告，对当前质量改进计划进行回顾性评估。
马里兰州巴尔的摩市约翰霍普金斯医学中心。
约翰霍普金斯医学中心员工。
从该计划的记录中检索数据，对疑似腺病毒结膜炎的员工在职业健康诊所进行评估，并进行聚合酶链反应（PCR）检测以筛查腺病毒结膜炎。记录有眼部投诉的员工的体征、症状、工作区域、诊断和处理情况，以及 PCR 结果和腺病毒类型。回顾了 5 年的数据。
从 2011 年到 2016 年，在 10000 名全职等效员工中，有 1059 名员工因怀疑患有腺病毒结膜炎而到职业健康诊所就诊。其中 104 人（10%）的腺病毒 PCR 检测呈阳性。在这些 PCR 阳性员工中，26 人（25%）的临床表现最差，即流行性角膜结膜炎（EKC）。门诊药房有最多的腺病毒结膜炎病例（n=9）。5 年来，红眼员工 PCR 阳性腺病毒结膜炎的比例呈上升趋势（P<.005，Cochrane-Armitage 趋势检验），EKC 患者的比例也呈上升趋势（P<.05）。由 37 型引起的 EKC 员工比例也有所增加（P<.05）。
腺病毒结膜炎占临床怀疑感染该病毒的员工病例的 10%。即使没有直接的患者接触，也应筛查在患者护理区域工作的员工。尽管 5 年来腺病毒结膜炎和 EKC 的比例有所增加，但未发生暴发。该政策有助于识别初期 EKC 暴发并指导感染控制工作。
