Direct costs and clinical impact of adenovirus genotype 8 conjunctivitis outbreak in a neonatology unit. (9th February 2021)

• Record Type: Journal Article
• Authors: Angueyra, María Florencia; Marcone, Débora Natalia; Escarrá, Florencia; Reyes, Noelia Soledad; Rubies, Yamile; Albas, Delcys; Rodríguez, Pamela Elizabeth; Vidaurreta, Santiago; Carballal, Guadalupe; Echavarria, Marcela
• Is Part Of: Infection control and hospital epidemiology. Volume 42:Number 2(2021)
• Page Start: 142
• Page End: 148
• Publication Date: 2021-02-09
• Subjects: Nosocomial infections -- Epidemiology -- Periodicals; Health facilities -- Sanitation -- Periodicals; Hospital buildings -- Sanitation -- Periodicals; Cross Infection -- Periodicals; Epidemiology -- Periodicals; Hospitals -- Periodicals; Infection Control -- Periodicals; 614.44
• DOI: 10.1017/ice.2020.404
• Languages: English
• ISSNs: 0899-823X

Abstract

Abstract: Objective: To report a conjunctivitis outbreak in a neonatology intensive care unit (NICU) and determine the associated economic impact. Design: Prospective observational study. Setting: Centro de Educación Médica e Investigaciones Clínicas (CEMIC) University Hospital, a private, tertiary-care healthcare institution in Buenos Aires, Argentina. Participants: The study included 52 NICU neonates and 59 NICU-related healthcare workers (HCWs) from CEMIC hospital. Methods: Neonates and HCWs were swabbed for real-time polymerase chain reaction (PCR) testing, viral culture, and typing by sequencing. Infection control measures, structural and logistic changes were implemented. Billing records were analyzed to determine costs. Results: From January 30 to April 28, 2018, 52 neonates were hospitalized in the NICU. Among them, 14 of 52 (21%) had bilateral conjunctivitis with pseudomembranes. Symptomatic neonates and HCWs were HAdV-D8 positive. Ophthalmological symptoms had a median duration of 18 days (IQR, 13–24.5). PCR positivity and infectious range had a median duration of 18.5 days. As part of containment measures, the NICU and the high-risk pregnancy unit were closed to new patients. The NICU was divided into 2 areas for symptomatic and asymptomatic patients; a new room was assigned for the general nursery, and all deliveries from the high-risk pregnancy unit were redirected to other hospitals. The outbreak cost the hospital US$205, 000: implementation of a new nursery room and extra salaries cost US$30, 350 and estimated productivity loss during 1 month cost US$175, 000. Conclusions: Laboratory diagnosis confirmed the cause of this outbreak as HAdV-D8. The immediate adoption and reinforcement of rigorous infection control measures limited the nosocomial viral spread. This outbreak represented a serious institutional problem, causing morbidity, significant economic loss, and absenteeism.