Rotavirus outbreak among adults in a university hospital in Germany.

BACKGROUND: Rotaviruses are the main cause of acute viral gastroenteritis in children under five years of age. Adults seem to be less frequently affected by rotaviruses most likely due to partial immunity resulting from prior infections. OBJECTIVES: To describe a hospital-associated outbreak of rotavirus infections among adults. STUDY DESIGN: Routine diagnostics and contact screening of symptomatic patients hospitalized at the university hospital of Freiburg. For rotavirus-positive patients, we performed rotavirus genotyping of all rotavirus RT-PCR positive samples and phylogenetic analysis. RESULTS: Between December 2016 and April 2017 routine diagnostics showed an unexpectedly high number of rotavirus infections among adults with the exception of one pediatric case. In total, 32 temporal-associated cases were identified. Among these, two asymptomatic cases were detected. Genotyping showed that all isolates belonged to rotavirus G2P[4]. Phylogenetic analysis confirmed an outbreak. Infection prevention and control successfully contained further spread. CONCLUSIONS: Infections with rotavirus are rare among adults but may spread between patients making timely recognition of rotavirus infections important for infection control. Rapid phylogenetic analysis is crucial for proactive infection control.

AMBU-KISS: quality control in ambulatory surgery.

BACKGROUND: Cost-containment measures have led to a constant increase in the number of patients cared for as outpatients. Several studies have demonstrated that surgical site infections result in considerable morbidity and excess health care costs from extended duration of hospitalization and antibiotic use. OBJECTIVE: AMBU-KISS is a protocol designed to create a reference database on surgical site infections for institutions involved in ambulatory surgery. METHODS: This study was carried out using a physician questionnaire. We compared surgical site infection rates for 3 indicator procedures in the ambulatory setting to those observed in the inpatient setting. The 3 indicator procedures chosen for the protocol were arthroscopic knee surgery and inguinal hernia and vein-stripping procedures. RESULTS: The arithmetic mean values of surgical site infection rates in arthroscopic surgery of the knee are 0.09% in the ambulatory setting and 0.11% in the hospital setting. For inguinal hernias, the respective rates are 0.65% and 0.78%. These differences, however, did not reach statistical significance (arthroscopic surgery, P = .8323 and inguinal herniotomies, P = .4895). A marked difference was observed for vein-stripping procedures, with surgical site infection rates of 0.38% in the ambulatory setting and 0.64% in the hospital setting. However, this difference was also not statistically significant, P = .1556. CONCLUSION: The AMBU-KISS protocol appears to be suitable for assessing and defining the magnitude of surgical site infections in ambulatory surgery. The preliminary results of our study show no significant differences for the 3 indicator procedures.