Hsing-Chen Tsai1, Meng-Tsen Tsai2, Wang-Huei Sheng3, Jann-Tay Wang3, Po-Nien Tsao4, Hung-Chieh Chou4, Chien-Yi Chen4, Luan-Yin Chang5, Chun-Yi Lu6, Li-Min Huang5. 1. Division of Pediatric Infectious Diseases, National Taiwan University Hospital, Taipei, Taiwan; Department of Pediatrics, New Taipei City Hospital, Taipei, Taiwan. 2. Center for Infection Control, National Taiwan University Hospital, Taipei, Taiwan; Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan. 3. Center for Infection Control, National Taiwan University Hospital, Taipei, Taiwan. 4. Division of Neonatology, Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan. 5. Division of Pediatric Infectious Diseases, National Taiwan University Hospital, Taipei, Taiwan. 6. Division of Pediatric Infectious Diseases, National Taiwan University Hospital, Taipei, Taiwan. Electronic address: cylu@ntu.edu.tw.
Abstract
BACKGROUND: During one week in September, one index case, followed by two cases of rotavirus gastroenteritis infection, was identified in a neonate intermediate care unit of a tertiary teaching children's hospital. An outbreak investigation was launched to clarify the possible infection source and to stop the spread of infection. METHODS: Cohort care and environmental disinfection were immediately implemented. We screened rotavirus in all the unit neonates' stool samples as well as environmental swab samples. The precautionary measures with regard to hand hygiene and contact isolation taken by healthcare providers and family members were re-examined. RESULTS: The fourth case was identified 5 days after commencement of the outbreak investigation. There were total 39 contacts, including 6 neonates, 8 family members, and 25 healthcare providers. Nineteen stool samples collected from other neonates in the units revealed one positive case (the fourth case). However, one sample taken from the computer keyboard and mouse in the ward was also positive. The observation of hygiene precautions and the use of isolation gowns by healthcare workers were found to be inadequate. Following the intensification of infection control measures, no further cases of infection were reported. CONCLUSIONS: Hand hygiene and an intensive isolation strategy remained the most critical precautions for preventing an outbreak of healthcare-associated viral gastroenteritis in the neonate care unit.
BACKGROUND: During one week in September, one index case, followed by two cases of rotavirus gastroenteritis infection, was identified in a neonate intermediate care unit of a tertiary teaching children's hospital. An outbreak investigation was launched to clarify the possible infection source and to stop the spread of infection. METHODS: Cohort care and environmental disinfection were immediately implemented. We screened rotavirus in all the unit neonates' stool samples as well as environmental swab samples. The precautionary measures with regard to hand hygiene and contact isolation taken by healthcare providers and family members were re-examined. RESULTS: The fourth case was identified 5 days after commencement of the outbreak investigation. There were total 39 contacts, including 6 neonates, 8 family members, and 25 healthcare providers. Nineteen stool samples collected from other neonates in the units revealed one positive case (the fourth case). However, one sample taken from the computer keyboard and mouse in the ward was also positive. The observation of hygiene precautions and the use of isolation gowns by healthcare workers were found to be inadequate. Following the intensification of infection control measures, no further cases of infection were reported. CONCLUSIONS: Hand hygiene and an intensive isolation strategy remained the most critical precautions for preventing an outbreak of healthcare-associated viral gastroenteritis in the neonate care unit.