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Evolution of an adenovirus outbreak in a multidisciplinary children's hospital.
Hatherill, M; Levin, M; Lawrenson, J; Hsiao, N-Y; Reynolds, L; Argent, A.
Afiliação
  • Hatherill M; Paediatric Intensive Care Unit, Red Cross Chidren's Hospital, Cape Town, South Africa. hatheril@ich.uct.ac.za
J Paediatr Child Health ; 40(8): 449-54, 2004 Aug.
Article em En | MEDLINE | ID: mdl-15265186
ABSTRACT

OBJECTIVE:

To describe the course of an evolving adenovirus outbreak in a multidisciplinary children's hospital with a high-risk patient population.

METHODS:

Observational study in a 280-bed university hospital during June 2002. Active case finding identified children with adenovirus infection. Data are median (interquartile range) or n (%). Adenovirus infection was diagnosed in 49 children, median age 12 months (4-33).

RESULTS:

New cases were diagnosed over 26 days and peaked on day 17 (n = 15). Total infected inpatients peaked on days 17-21 (n = 36). Twenty-three infections (47%) were community-acquired and 26 (53%) hospital-acquired. Thirty-three children (67%) had a coexistent high-risk condition. Median hospital stay before and after diagnosis was 9 days (3-18) and 9 days (4-29), respectively. Twenty-two children (45%) were admitted to PICU. Overall hospital mortality was 22% (n = 11) and mortality attributed to adenoviral disease 12% (n = 6). Hospital mortality was similar between community- and hospital-acquired infections (22% compared to 23%) (P = 1.0). Twenty children (41%) received intravenous immunoglobulin (IVIG). Children treated with IVIG had a longer hospital stay (median 40 days vs 14 days) than those who did not receive IVIG (P = 0.01). Neither PICU mortality (29% vs 12%), nor hospital mortality (35% vs 14%), differed significantly between IVIG treated and untreated children (P = 0.76 and P = 0.16, respectively).

CONCLUSION:

The rapid spread of hospital-acquired adenovirus underlines the importance of effective infection control measures. Despite nosocomial infection amongst high-risk patients, mortality was similar to that of community-acquired infection. Administration of immunoglobulin was not associated with demonstrable benefit. A prospective randomized trial would be required to resolve this issue.
Assuntos
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Coleções: 01-internacional Temas: Geral Base de dados: MEDLINE Assunto principal: Pneumonia Viral / Infecção Hospitalar Tipo de estudo: Clinical_trials / Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies Limite: Child / Child, preschool / Humans / Infant Idioma: En Revista: J Paediatr Child Health Assunto da revista: PEDIATRIA Ano de publicação: 2004 Tipo de documento: Article País de afiliação: África do Sul
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Coleções: 01-internacional Temas: Geral Base de dados: MEDLINE Assunto principal: Pneumonia Viral / Infecção Hospitalar Tipo de estudo: Clinical_trials / Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies Limite: Child / Child, preschool / Humans / Infant Idioma: En Revista: J Paediatr Child Health Assunto da revista: PEDIATRIA Ano de publicação: 2004 Tipo de documento: Article País de afiliação: África do Sul