Nosocomial AKC Infections Prevented by Infection Control Measures Identification and Control of Nosocomial Adenovirus Keratoconjunctivitis in an Ophthalmic Department

Objective: To evaluate the frequency of nosocomial adenoviral keratoconjunctivitis (AKC) infection and to assess the effect of an improved infection control policy on reduction of its incidence. Design: Prospective, observational, clinical study. Participants/Methods: Patients with suspected AKC and treated at Moorefields Eye Hospital emergency department were evaluated as well as a collection of viral cultures. Those who developed a confirmed infection within 3 weeks of another visit to the eye unit for an unrelated, noninfectious condition were considered to have a nosocomial infection. The proportion of cases of nosocomial and community-acquired AKC was compared before and after implementation of an improved infection control policy that included segregation of patients with suspected infection to their own waiting area and the use of an examination room dedicated to the evaluation of patients suspected of having an ocular infection. Results: During the first 12 months after implementation of the new infection control policies, the proportion of patients with AKC decreased from 48% to 25%. During the subsequent 12 months, once the staff was fully cooperative with the new policies, the proportion of nosocomial cases decreased to 3.4%. Conclusions: The incidence of nosocomial AKC can be dramatically reduced by implementation of a strict infection control policy that includes segregation of patients and use of dedicated equipment for their evaluation. Reviewer's Comments: Adenoviral infections are the most common infections encountered by ophthalmologists. In this day and age, every effort must be made to reduce the risk of cross contamination of patients in our offices. This study illustrates important steps that can be implemented to achieve this goal. (Reviewer-Scott D. Smith, MD, MPH).