Cross-infection of Adenovirus among Medical Staff: A Warning from Intensive Care Unit in a Tertiary Care Teaching Hospital in China.

Abstract Rationale In 2019, a small HAdV55-associated outbreak of adenovirus infection occurred among the intensive care unit (ICU) staff in Xiangya Hospital of Central South University in Hunan Province, China during the treatment of a patient. Objective To investigate the characteristics of a nosocomial adenovirus outbreak in the ICU. Methods We evaluated all the patients treated and the medical staff working in the ICU from August 1 to September 4, 2019. We further performed an epidemiological and molecular analysis for this outbreak from patient to healthcare workers and between healthcare workers. After the outbreak, we adopted exposure prevention and droplet prevention measures based on standard precautions. Measurements and Main Results Between August 1 and August 27, 2019, 27 cases of human adenovirus cross-infection were reported in our institution. Among the cases, 11 were doctors (41%), 11 were nurses (41%), three were respiratory therapists (11%), and two were caregivers (7%). The attack rate was 28.4% and the fatality rate was 0. The results showed that contact with the index case, lack of hand hygiene or gloving adherence was a risk factor for infection after adenovirus exposure. After taking specific precautions, no new cases of infection have appeared since August 27. Conclusions Our results show that HAdV55 in a single patient had strong transmission potential in an intensive care unit with adequate facilities and standardized operation. We provide convincing evidence indicating that attention could be highlighted the role of standard and specific precautions in controlling the spread of adenovirus in ICUs.