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

Published online by Cambridge University Press:  09 September 2020

María Florencia Angueyra Open the ORCID record for María Florencia Angueyra [Opens in a new window] ,
Débora Natalia Marcone ,
Florencia Escarrá ,
Noelia Soledad Reyes ,
Yamile Rubies ,
Delcys Albas ,
Pamela Elizabeth Rodríguez ,
Santiago Vidaurreta ,
Guadalupe Carballal  and
Marcela Echavarria
María Florencia Angueyra
Affiliation:
Virology Unit (UNVIR-CONICET), Centro de Educación Médica e Investigaciones Clínicas (CEMIC) University Hospital, CABA, Buenos Aires, Argentina
Débora Natalia Marcone
Affiliation:
Virology Unit (UNVIR-CONICET), Centro de Educación Médica e Investigaciones Clínicas (CEMIC) University Hospital, CABA, Buenos Aires, Argentina
Florencia Escarrá
Affiliation:
Department of Paediatrics, CEMIC, CABA, Buenos Aires, Argentina
Noelia Soledad Reyes
Affiliation:
Virology Unit (UNVIR-CONICET), Centro de Educación Médica e Investigaciones Clínicas (CEMIC) University Hospital, CABA, Buenos Aires, Argentina
Yamile Rubies
Affiliation:
Neonatology Unit, CEMIC, CABA, Buenos Aires, Argentina
Delcys Albas
Affiliation:
Neonatology Unit, CEMIC, CABA, Buenos Aires, Argentina
Pamela Elizabeth Rodríguez
Affiliation:
Virology Unit (UNVIR-CONICET), Centro de Educación Médica e Investigaciones Clínicas (CEMIC) University Hospital, CABA, Buenos Aires, Argentina
Santiago Vidaurreta
Affiliation:
Department of Paediatrics, CEMIC, CABA, Buenos Aires, Argentina
Guadalupe Carballal
Affiliation:
Virology Unit (UNVIR-CONICET), Centro de Educación Médica e Investigaciones Clínicas (CEMIC) University Hospital, CABA, Buenos Aires, Argentina Clinical Virology Laboratory, CEMIC, CABA, Buenos Aires, Argentina
Marcela Echavarria*
Affiliation:
Virology Unit (UNVIR-CONICET), Centro de Educación Médica e Investigaciones Clínicas (CEMIC) University Hospital, CABA, Buenos Aires, Argentina Clinical Virology Laboratory, CEMIC, CABA, Buenos Aires, Argentina
*
Author for correspondence: Marcela Echavarria, E-mail: Mechavarria@cemic.edu.ar
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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.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 42 , Issue 2 , February 2021 , pp. 142 - 148
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Copyright
© 2020 by The Society for Healthcare Epidemiology of America. All rights reserved.

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