Outbreak of adenovirus D8 in a neonatal intensive care unit involving multiple simultaneous transmission pathways.

BACKGROUND: Adenovirus (ADV) outbreaks in neonatal intensive care units (NICU) can lead to durable transmission and serious adverse outcomes. This study describes the investigation and control of an ADV-D8 outbreak in an NICU, associated with ophthalmologic equipment used during retinopathy of prematurity (ROP) screening. Cases were observed in neonates, parents and nurses. METHODS: The outbreak investigation was performed including sampling patients, parents and health care workers as well as the environment for molecular detection of ADV DNA. The investigation was also conducted in the guest house where some parents were temporary residents. A retrospective cohort study focused on neonates hospitalized during the epidemic period to assess the risk associated with ROP examination. RESULTS: Fifteen cases were identified in neonates; all but one presented with conjunctivitis. Two healthcare workers and 18 parents acquired conjunctivitis. ADV DNA was identified on the RetCam and on the freezer shared by parents. All ADV-positive samples were typed as ADV-D8. ADV infections occurred more frequently in neonates who had ROP examinations (37.8% (14/37) vs (0.9% (1/110); P<0.001) (relative risk 41.6; (5.7-305.8)). The RetCam was disinfected between two examinations using a disinfectant that was virucidal on ADV after a 30-min contact. CONCLUSION: This outbreak was significantly associated with ROP examination with a RetCam that had a disinfection protocol ill-adapted to rapid patient turnover. In addition, nosocomial transmission via the parents to neonates and parent-to-parent transmission is likely to have played a role in the dissemination of cases. No further cases were observed after the new disinfection procedure was enforced.

Steroid saponins from fenugreek seeds: extraction, purification, and pharmacological investigation on feeding behavior and plasma cholesterol.

The seeds of fenugreek (Trigonella foenum graecum L.) are traditionally assumed to have restorative properties. We have recently shown that a fenugreek seed extract containing steroid saponins increased food consumption and induced hypocholesterolemia in rats. This study aims to investigate the specific role of purified steroid saponins in these properties. For this purpose, an original technique for extraction and purification of steroid saponins was carried out. Thereafter, the effects of these steroid saponins were investigated on feeding behavior and metabolic endocrine changes in normal and diabetic rats. All the steroid saponins (furostanol type) were extracted from the seeds and separated from all other constituents of the entire extract by using several purification procedures to give an extract containing at least 90% of steroid saponins. Pharmcological experiments were performed in vivo in normal and streptozotocin diabetic rats: steroid saponins were administered chronically mixed with food (12.5 mg/day per 300 g body weight). Our data show that the treatment with steroid saponins significantly increased food intake and the motivation to eat in normal rats, while modifying the circadian rhythm of feeding behavior; it also stabilized the food consumption in diabetic rats, which resulted in a progressive weight gain in these animals, in contrast to untreated diabetic controls. Both in normal and diabetic rats, steroid saponins decreased total plasma cholesterol without any change in triglycerides. In conclusion, the present work reports a clear methodology to obtain all the steroid saponins and demonstrates that these saponins enhance food consumption and motivation to eat, and reduce plasma cholesterol levels in rats.