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Adenovirus pseudo-outbreak associated with bronchoscopy.

Walter C Hellinger¹, Heather C Parth², Brenda T Smith²

¹Division of Infectious Diseases, Mayo Clinic, Jacksonville, Florida.

Infection Control and Hospital Epidemiology

|August 29, 2019

Summary

Multiplex PCR analysis of respiratory specimens identified adenovirus in a surgical ICU. This was later determined to be a pseudo-outbreak, not a true hospital-acquired infection.

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Area of Science:

Clinical Microbiology
Infectious Diseases
Respiratory Medicine

Background:

Community-acquired respiratory viruses are a concern in healthcare settings.
Multiplex polymerase chain reaction (PCR) is a key diagnostic tool.
Intensive care units (ICUs) are vulnerable to respiratory pathogen transmission.

Purpose of the Study:

To investigate an apparent increase in adenovirus cases.
To differentiate between true outbreaks and laboratory-associated events.
To assess the impact of diagnostic methods on outbreak detection.

Main Methods:

Regular application of multiplex PCR for respiratory viruses on bronchoalveolar specimens.
Retrospective analysis of patient data and laboratory results.
Epidemiological investigation to identify the source of adenovirus detection.

Main Results:

Adenovirus was identified in multiple patients within a surgical ICU.
The detection occurred over a specific period, suggesting a potential outbreak.
Further investigation revealed the findings were attributed to a pseudo-outbreak.

Conclusions:

Diagnostic methods like multiplex PCR can detect pathogens but require careful interpretation.
Pseudo-outbreaks can occur due to various factors, including laboratory processes.
Distinguishing true outbreaks from pseudo-outbreaks is crucial for appropriate infection control measures.