Singh-Naz N, Brown M, Ganeshananthan M
Department of Infectious Diseases and Epidemiology, Children's National Medical Center, George Washington University School of Medicine and Health Sciences, Washington, DC 20010.
Pediatr Infect Dis J. 1993 Nov;12(11):922-5.
Nosocomial transmission of adenovirus type 3 associated with fatalities in infants has not been frequently reported. This report describes the nosocomial spread of adenovirus types 2 and 3 among infants with bronchopulmonary dysplasia in a chronic (transitional) care facility. The index case developed pneumonia with a clinical deterioration in respiratory status 8 days after admission. Within the next 10 to 30 days 9 other infants and 2 health care personnel became ill with respiratory symptoms. Three of these 10 infants had progressive respiratory failure and 2 of them died. All of these infants had underlying chronic lung disease of bronchopulmonary dysplasia. The overall attack rate was 30% (10 of 33). Further spread of adenovirus was prevented by using barrier precautions and masks while performing tracheostomy care. Adenovirus isolates were serotyped as Ad3 in 4 patients and 1 staff member, as Ad2 in 3 patients, and as a combination of Ad2 and Ad3 in 1 patient. Two fatalities were associated with Ad3 infection. Three isolates from 2 patients and 1 staff member were not available for typing. Restriction endonuclease analysis was performed on all of these isolates of Ad3 and Ad2. There was no genetic heterogeneity in the isolates, suggesting a common source.
3型腺病毒在医院内传播并导致婴儿死亡的情况此前鲜有报道。本报告描述了2型和3型腺病毒在一家慢性（过渡性）护理机构中患有支气管肺发育不良的婴儿之间的医院内传播情况。首例病例在入院8天后出现肺炎，呼吸状况临床恶化。在接下来的10至30天内，另外9名婴儿和2名医护人员出现呼吸道症状。这10名婴儿中有3名出现进行性呼吸衰竭，其中2名死亡。所有这些婴儿都患有支气管肺发育不良的潜在慢性肺部疾病。总体发病率为30%（33例中的10例）。在进行气管造口护理时，通过采取屏障预防措施和佩戴口罩，防止了腺病毒的进一步传播。腺病毒分离株在4名患者和1名工作人员中被鉴定为Ad3，在3名患者中被鉴定为Ad2，在1名患者中被鉴定为Ad2和Ad3的组合。两例死亡与Ad3感染有关。来自2名患者和1名工作人员的3份分离株无法进行分型。对所有这些Ad3和Ad2分离株进行了限制性内切酶分析。分离株中没有基因异质性，表明有共同来源。
