流行性角結膜炎の院内感染の検討

Review of a nosocomical outbreak of epidemic keratoconjunctivitis

　流行性角結膜炎の院内感染が，2003年3月10日に当院の病棟で発生した。入院患者4例と外来患者10例を臨床所見から流行性角結膜炎と診断した。これら14例をアデノチェック^(R)で検索し，11例が陽性であった。5例に中和抗体値測定とウイルスの分離を行い，4例でアデノウイルス37型が同定された。検査器具や医療従事者を介した感染が原因として考えられた。病棟内で発生した翌日から感染対策委員会を招集し，新規に作成したプロトコールに基づいて感染拡大の予防を徹底した。診療機器と手指の消毒，スタッフへの指導，患者への説明会，別室での診療，入院制限などにより，病棟閉鎖や外来制限をすることなく，初発から44日目に警戒体制を解除できた。

A nosocomical infection of epidemic keratoconjunctivitis occurred in our hospital on March 10,2003. A total of 14 patients were diagnosed with the disease. The series comprised 4 in-patients and 11 outpatients. Immunochromatography for adenovirus gave positive results in 11 patients. Sera from 5 patients were examined by polymerase chain reaction and adnovirus neutralizing antibody test. Adenovirus type 37 was identified in 4 patients. It appeared that the infection was caused through instruments,examinations,or treatments in the hospital. An infection-control committee was called on March 11. Utmost efforts were made to prevent further infection following a new protocol including：sterilization of instruments and hands,explanatory meetings for patients,examination of infected patients in a separate room,and restriction of hospitalization. By these measures,the outbreak was announced to have ended 44 days after onset.