Use of real-time semiquantitative PCR data in management of a neonatal intensive care unit adenovirus outbreak

Nicholas D. Hysmith, Mary R. Tanner, Sandra Arnold, Steven C. Buckingham, Anami R. Patel, Ramasubbareddy Dhanireddy, Katha Comeaux, Joy Joyner, Mary Ellen Hoehn, John Devincenzo

Research output: Contribution to journalArticle

Abstract

Objective To describe an adenovirus outbreak in a neonatal intensive care unit (NICU), including the use of qualitative and semiquantitative real-time polymerase chain reaction (qPCR) data to inform the outbreak response.Design Mixed prospective and retrospective observational study.Setting A level IV NICU in the southeastern United States.Patients Two adenovirus cases were identified in a NICU. Screening of all inpatients with qPCR on nasopharyngeal specimens revealed 11 additional cases.Interventions Outbreak response procedures, including enhanced infection control policies, were instituted. Serial qPCR studies were used to screen for new infections among exposed infants and to monitor viral clearance among cases. Changes to retinopathy of prematurity (ROP) exam procedures were made after an association was noted in those patients. At the end of the outbreak, a retrospective review allowed for comparison of clinical factors between the infected and uninfected groups.Results There were no new cases among patients after outbreak identification. One adenovirus-infected patient died; the others recovered their clinical baselines. The ROP exams were associated with an increased risk of infection (odds ratio [OR], 84.6; 95% confidence interval [CI], 4.5-1,601). The duration of the outbreak response was 33 days, and the previously described second wave of cases after the end of the outbreak did not occur. Revisions to infection control policies remained in effect following the outbreak.Conclusions Retinopathy of prematurity exams are potential mechanisms of adenovirus transmission, and autoclaved or single-use instruments should be used to minimize this risk. Real-time molecular diagnostic and quantification data guided outbreak response procedures, which rapidly contained and fully terminated a NICU adenovirus outbreak.

Original languageEnglish (US)
Pages (from-to)1074-1079
Number of pages6
JournalInfection Control and Hospital Epidemiology
Volume39
Issue number9
DOIs
StatePublished - Sep 1 2018

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Neonatal Intensive Care Units
Adenoviridae
Disease Outbreaks
Real-Time Polymerase Chain Reaction
Retinopathy of Prematurity
Infection Control
Southeastern United States
Molecular Pathology
Infection
Observational Studies
Inpatients
Retrospective Studies
Odds Ratio
Confidence Intervals

All Science Journal Classification (ASJC) codes

  • Epidemiology
  • Microbiology (medical)
  • Infectious Diseases

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Use of real-time semiquantitative PCR data in management of a neonatal intensive care unit adenovirus outbreak. / Hysmith, Nicholas D.; Tanner, Mary R.; Arnold, Sandra; Buckingham, Steven C.; Patel, Anami R.; Dhanireddy, Ramasubbareddy; Comeaux, Katha; Joyner, Joy; Hoehn, Mary Ellen; Devincenzo, John.

In: Infection Control and Hospital Epidemiology, Vol. 39, No. 9, 01.09.2018, p. 1074-1079.

Research output: Contribution to journalArticle

Hysmith, Nicholas D. ; Tanner, Mary R. ; Arnold, Sandra ; Buckingham, Steven C. ; Patel, Anami R. ; Dhanireddy, Ramasubbareddy ; Comeaux, Katha ; Joyner, Joy ; Hoehn, Mary Ellen ; Devincenzo, John. / Use of real-time semiquantitative PCR data in management of a neonatal intensive care unit adenovirus outbreak. In: Infection Control and Hospital Epidemiology. 2018 ; Vol. 39, No. 9. pp. 1074-1079.
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AU - Dhanireddy, Ramasubbareddy

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