Direct costs and clinical impact of Adenovirus genotype 8 conjunctivitis outbreak in a neonatology unit

ANGUEYRA F; MARCONE D; ESCARRÁ FLORENCIA; REYES N; RUBIES YAMILE; ALBAS DELCYS; RODRIGUEZ PAMELA ELIZABETH; VIDAURRETA SANTIAGO; CARBALLAL GUADALUPE; ECHAVARRIA MARCELA

INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY

UNIV CHICAGO PRESS

Lugar: Chicago; Año: 2020 p. 1 - 7

0899-823X

Adenoviruses (AdV), a main cause of epidemic keratoconjunctivitis, are unusually stable and can persist for long periods (3 weeks) in the environment. Objective: To describe a conjunctivitis outbreak in a neonatal intensive care unit (NICU) and to determine the associated economic loss.Conjunctival swabs from 22 neonates and 60 health care workers were tested for AdV by Real-time PCR, AdV typing was done by sequencing a portion of the hexon gene. Infection control measures and structural changes were implemented. Hospital associated costs were calculated from billing records. From February 28-March 25, 2018, 11/22 (50%) neonates were AdV positive. Patients developed bilateral conjunctivitis with pseudomembranes. Opthalmological symptoms had a median of 23.6 days (IQR 18-36). All 11 samples were AdV genotype-D8. A total of 15/60 (25%) healthcare workers were AdV PCR positive and had to be licensed. The NICU was divided into two separate areas (AdV-positive patients and AdV-negative patients). A different room was assigned for the general nursery (healthy new borns). High-risk pregnancy deliveries were redirected to other hospitals. The cost increase for implementing the new nursery room and extra personnel was U$S 30.350. The estimated loss for not addmitting deliveries from high-risk pregnancies during one month was U$S 175.000.Conclusions Laboratory diagnosis confirmed the cause of this outbreak as AdV genotype-D8. The immediate adoption and reinforcement of rigorous infection control measures limited the nosocomial spread of such a resistant virus. This outbreak represented a serious institutional problem, causing remarkable morbidity, significant economic loss and absenteeism.