{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T19:04:55Z","timestamp":1781723095596,"version":"3.54.5"},"reference-count":28,"publisher":"Cambridge University Press (CUP)","issue":"9","license":[{"start":{"date-parts":[[2018,7,18]],"date-time":"2018-07-18T00:00:00Z","timestamp":1531872000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2018,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S0899823X18001629_abs1\" sec-type=\"general\"><jats:title>Objective<\/jats:title><jats:p>To describe an adenovirus outbreak in a neonatal intensive care unit (NICU), including the use of qualitative and semiquantitative real-time polymerase chain reaction (qPCR) data to inform the outbreak response.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X18001629_abs2\" sec-type=\"general\"><jats:title>Design<\/jats:title><jats:p>Mixed prospective and retrospective observational study.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X18001629_abs3\" sec-type=\"general\"><jats:title>Setting<\/jats:title><jats:p>A level IV NICU in the southeastern United States.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X18001629_abs4\" sec-type=\"general\"><jats:title>Patients<\/jats:title><jats:p>Two adenovirus cases were identified in a NICU. Screening of all inpatients with qPCR on nasopharyngeal specimens revealed 11 additional cases.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X18001629_abs5\" sec-type=\"general\"><jats:title>Interventions<\/jats:title><jats:p>Outbreak response procedures, including enhanced infection control policies, were instituted. Serial qPCR studies were used to screen for new infections among exposed infants and to monitor viral clearance among cases. Changes to retinopathy of prematurity (ROP) exam procedures were made after an association was noted in those patients. At the end of the outbreak, a retrospective review allowed for comparison of clinical factors between the infected and uninfected groups.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X18001629_abs6\" sec-type=\"results\"><jats:title>Results<\/jats:title><jats:p>There were no new cases among patients after outbreak identification. One adenovirus-infected patient died; the others recovered their clinical baselines. The ROP exams were associated with an increased risk of infection (odds ratio [OR], 84.6; 95% confidence interval [CI], 4.5\u20131,601). The duration of the outbreak response was 33 days, and the previously described second wave of cases after the end of the outbreak did not occur. Revisions to infection control policies remained in effect following the outbreak.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X18001629_abs7\" sec-type=\"conclusions\"><jats:title>Conclusions<\/jats:title><jats:p>Retinopathy of prematurity exams are potential mechanisms of adenovirus transmission, and autoclaved or single-use instruments should be used to minimize this risk. Real-time molecular diagnostic and quantification data guided outbreak response procedures, which rapidly contained and fully terminated a NICU adenovirus outbreak.<\/jats:p><\/jats:sec>","DOI":"10.1017\/ice.2018.162","type":"journal-article","created":{"date-parts":[[2018,7,18]],"date-time":"2018-07-18T19:18:01Z","timestamp":1531941481000},"page":"1074-1079","source":"Crossref","is-referenced-by-count":9,"title":["Use of real-time semiquantitative PCR data in management of a neonatal intensive care unit adenovirus outbreak"],"prefix":"10.1017","volume":"39","author":[{"given":"Nicholas D.","family":"Hysmith","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary R.","family":"Tanner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra R.","family":"Arnold","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven C.","family":"Buckingham","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anami R.","family":"Patel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramasubbareddy","family":"Dhanireddy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katha","family":"Comeaux","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joy","family":"Joyner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary Ellen","family":"Hoehn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John P.","family":"DeVincenzo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2018,7,18]]},"reference":[{"key":"S0899823X18001629_ref24","doi-asserted-by":"publisher","DOI":"10.1016\/S0196-6553(96)90066-8"},{"key":"S0899823X18001629_ref11","doi-asserted-by":"crossref","first-page":"1067","DOI":"10.1016\/B978-1-4377-2702-9.00212-9","volume-title":"Principles and Practice of Pediatric Infectious Diseases","author":"Allen","year":"2012"},{"key":"S0899823X18001629_ref13","first-page":"11","article-title":"Quantitative real-time polymerase chain reaction for the core facility using TaqMan and the Perkin-Elmer\/Applied Biosystems Division 7700 sequence detector","volume":"10","author":"Grove","year":"1999","journal-title":"J Biomolec Tech"},{"key":"S0899823X18001629_ref6","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2004.11.032"},{"key":"S0899823X18001629_ref20","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2012-2996"},{"key":"S0899823X18001629_ref4","doi-asserted-by":"publisher","DOI":"10.1086\/502247"},{"key":"S0899823X18001629_ref18","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0b013e3181d743c8"},{"key":"S0899823X18001629_ref7","doi-asserted-by":"publisher","DOI":"10.1016\/S1386-6532(03)00011-8"},{"key":"S0899823X18001629_ref14","doi-asserted-by":"publisher","DOI":"10.1038\/pr.2012.176"},{"key":"S0899823X18001629_ref15","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-9-63"},{"key":"S0899823X18001629_ref2","doi-asserted-by":"publisher","DOI":"10.1136\/adc.68.5_Spec_No.610"},{"key":"S0899823X18001629_ref28","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2004.06.015"},{"key":"S0899823X18001629_ref1","first-page":"73","article-title":"Nosocomial outbreak of epidemic keratoconjunctivitis in a neonatal intensive care unit","volume":"82","author":"Asencio-Duran","year":"2007","journal-title":"Arch Sociedad Espa\u00f1ola de Oftalmol"},{"key":"S0899823X18001629_ref3","doi-asserted-by":"publisher","DOI":"10.3109\/09286586.2012.718402"},{"key":"S0899823X18001629_ref5","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhin.2011.11.007"},{"key":"S0899823X18001629_ref8","doi-asserted-by":"publisher","DOI":"10.1097\/00006454-199206000-00008"},{"key":"S0899823X18001629_ref9","doi-asserted-by":"publisher","DOI":"10.1016\/S0161-6420(93)31389-8"},{"key":"S0899823X18001629_ref10","unstructured":"American Academy of Pediatrics. \u201cAdenovirus.\u201d In Kimberlin DW, Brady MT, Jackson MA, Long, SS, eds. 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