Cargando…

1261. Utility of a Multiplex Molecular Gastrointestinal Panel in Rapid Identification and Control of a Norovirus Outbreak in a Pediatric Tertiary Care Center

BACKGROUND: Norovirus is one of the most common viral pathogens implicated in gastroenteritis outbreaks in community and healthcare settings. The virus’ short incubation period and high attack rate allow its rapid spread through inpatient wards to patients (Patients), staff and visitors. Early ident...

Descripción completa

Detalles Bibliográficos
Autores principales: Comeau, Jeannette L, Ivany, Allana M, Romeo, Terry, Maxwell, Bridget S, Nymark, Natalie, MacKinnon, Belinda, Doon, Erin, Mailman, Tim
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6252859/
http://dx.doi.org/10.1093/ofid/ofy210.1094
_version_ 1783373361868439552
author Comeau, Jeannette L
Ivany, Allana M
Romeo, Terry
Maxwell, Bridget S
Nymark, Natalie
MacKinnon, Belinda
Doon, Erin
Mailman, Tim
author_facet Comeau, Jeannette L
Ivany, Allana M
Romeo, Terry
Maxwell, Bridget S
Nymark, Natalie
MacKinnon, Belinda
Doon, Erin
Mailman, Tim
author_sort Comeau, Jeannette L
collection PubMed
description BACKGROUND: Norovirus is one of the most common viral pathogens implicated in gastroenteritis outbreaks in community and healthcare settings. The virus’ short incubation period and high attack rate allow its rapid spread through inpatient wards to patients (Patients), staff and visitors. Early identification and appropriate implementation of infection prevention and control measures is essential to interrupt transmission. METHODS: The IWK Health Centre is a 250-bed tertiary care Pediatric and Women’s hospital serving the Maritime Provinces, Canada. We describe a norovirus outbreak in our Pediatric Medical Unit, a 24-bed, single room ward with individual bathrooms for patients and families. Hospital-acquired norovirus definition: Patients admitted ≥48 hours with lab-confirmed norovirus AND ≥ 1 of: (1) acute onset diarrhea (no noninfectious cause) or (2) ≥2 of: nausea, vomiting, abdominal pain, fever, or headache. In 2017 the FilmArray Gastrointestinal (GI) Panel was introduced in the Clinical Microbiology Laboratory as part of a prospective post-implementation study. Since then, stool samples sent for viral, bacterial, or parasitic testing are evaluated by PCR. The panel tests for 22 GI analytes, including five viruses, with a 2-hour turnaround time. Previously, in-house stool viral testing was limited to adeno- and rotavirus antigen. Patient characteristics were collected and analyzed for this study. RESULTS: Patients 1, 2, and 3 had new onset diarrhea and emesis; Pt 1 on day 0, and Patients 2 and 3 on day 1. Patient 3’s parents (likely source) had had diarrhea and emesis on days 3 and 2, and used the ward kitchen. Two care-givers of Patient 2, and 1 medical resident developed diarrhea and emesis over days 0 to 2. The outbreak was declared over on day 7. Patients 1, 2, and 3 all tested positive for norovirus in stool on day 1. On days 2–3, six other patients with diarrhea tested norovirus negative. All symptomatic patients were immediately placed on contact precautions, room/ward cleaning frequency increased and proper hand hygiene was reinforced. Common areas (playroom/kitchen) were closed until the outbreak was over. All patients with loose stool were tested during the outbreak. CONCLUSION: FilmArrayGI panel enabled same-day identification of norovirus in this single-ward outbreak and permitted real-time identification of the termination of the outbreak. DISCLOSURES: All authors: No reported disclosures.
format Online
Article
Text
id pubmed-6252859
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher Oxford University Press
record_format MEDLINE/PubMed
spelling pubmed-62528592018-11-28 1261. Utility of a Multiplex Molecular Gastrointestinal Panel in Rapid Identification and Control of a Norovirus Outbreak in a Pediatric Tertiary Care Center Comeau, Jeannette L Ivany, Allana M Romeo, Terry Maxwell, Bridget S Nymark, Natalie MacKinnon, Belinda Doon, Erin Mailman, Tim Open Forum Infect Dis Abstracts BACKGROUND: Norovirus is one of the most common viral pathogens implicated in gastroenteritis outbreaks in community and healthcare settings. The virus’ short incubation period and high attack rate allow its rapid spread through inpatient wards to patients (Patients), staff and visitors. Early identification and appropriate implementation of infection prevention and control measures is essential to interrupt transmission. METHODS: The IWK Health Centre is a 250-bed tertiary care Pediatric and Women’s hospital serving the Maritime Provinces, Canada. We describe a norovirus outbreak in our Pediatric Medical Unit, a 24-bed, single room ward with individual bathrooms for patients and families. Hospital-acquired norovirus definition: Patients admitted ≥48 hours with lab-confirmed norovirus AND ≥ 1 of: (1) acute onset diarrhea (no noninfectious cause) or (2) ≥2 of: nausea, vomiting, abdominal pain, fever, or headache. In 2017 the FilmArray Gastrointestinal (GI) Panel was introduced in the Clinical Microbiology Laboratory as part of a prospective post-implementation study. Since then, stool samples sent for viral, bacterial, or parasitic testing are evaluated by PCR. The panel tests for 22 GI analytes, including five viruses, with a 2-hour turnaround time. Previously, in-house stool viral testing was limited to adeno- and rotavirus antigen. Patient characteristics were collected and analyzed for this study. RESULTS: Patients 1, 2, and 3 had new onset diarrhea and emesis; Pt 1 on day 0, and Patients 2 and 3 on day 1. Patient 3’s parents (likely source) had had diarrhea and emesis on days 3 and 2, and used the ward kitchen. Two care-givers of Patient 2, and 1 medical resident developed diarrhea and emesis over days 0 to 2. The outbreak was declared over on day 7. Patients 1, 2, and 3 all tested positive for norovirus in stool on day 1. On days 2–3, six other patients with diarrhea tested norovirus negative. All symptomatic patients were immediately placed on contact precautions, room/ward cleaning frequency increased and proper hand hygiene was reinforced. Common areas (playroom/kitchen) were closed until the outbreak was over. All patients with loose stool were tested during the outbreak. CONCLUSION: FilmArrayGI panel enabled same-day identification of norovirus in this single-ward outbreak and permitted real-time identification of the termination of the outbreak. DISCLOSURES: All authors: No reported disclosures. Oxford University Press 2018-11-26 /pmc/articles/PMC6252859/ http://dx.doi.org/10.1093/ofid/ofy210.1094 Text en © The Author(s) 2018. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Abstracts
Comeau, Jeannette L
Ivany, Allana M
Romeo, Terry
Maxwell, Bridget S
Nymark, Natalie
MacKinnon, Belinda
Doon, Erin
Mailman, Tim
1261. Utility of a Multiplex Molecular Gastrointestinal Panel in Rapid Identification and Control of a Norovirus Outbreak in a Pediatric Tertiary Care Center
title 1261. Utility of a Multiplex Molecular Gastrointestinal Panel in Rapid Identification and Control of a Norovirus Outbreak in a Pediatric Tertiary Care Center
title_full 1261. Utility of a Multiplex Molecular Gastrointestinal Panel in Rapid Identification and Control of a Norovirus Outbreak in a Pediatric Tertiary Care Center
title_fullStr 1261. Utility of a Multiplex Molecular Gastrointestinal Panel in Rapid Identification and Control of a Norovirus Outbreak in a Pediatric Tertiary Care Center
title_full_unstemmed 1261. Utility of a Multiplex Molecular Gastrointestinal Panel in Rapid Identification and Control of a Norovirus Outbreak in a Pediatric Tertiary Care Center
title_short 1261. Utility of a Multiplex Molecular Gastrointestinal Panel in Rapid Identification and Control of a Norovirus Outbreak in a Pediatric Tertiary Care Center
title_sort 1261. utility of a multiplex molecular gastrointestinal panel in rapid identification and control of a norovirus outbreak in a pediatric tertiary care center
topic Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6252859/
http://dx.doi.org/10.1093/ofid/ofy210.1094
work_keys_str_mv AT comeaujeannettel 1261utilityofamultiplexmoleculargastrointestinalpanelinrapididentificationandcontrolofanorovirusoutbreakinapediatrictertiarycarecenter
AT ivanyallanam 1261utilityofamultiplexmoleculargastrointestinalpanelinrapididentificationandcontrolofanorovirusoutbreakinapediatrictertiarycarecenter
AT romeoterry 1261utilityofamultiplexmoleculargastrointestinalpanelinrapididentificationandcontrolofanorovirusoutbreakinapediatrictertiarycarecenter
AT maxwellbridgets 1261utilityofamultiplexmoleculargastrointestinalpanelinrapididentificationandcontrolofanorovirusoutbreakinapediatrictertiarycarecenter
AT nymarknatalie 1261utilityofamultiplexmoleculargastrointestinalpanelinrapididentificationandcontrolofanorovirusoutbreakinapediatrictertiarycarecenter
AT mackinnonbelinda 1261utilityofamultiplexmoleculargastrointestinalpanelinrapididentificationandcontrolofanorovirusoutbreakinapediatrictertiarycarecenter
AT doonerin 1261utilityofamultiplexmoleculargastrointestinalpanelinrapididentificationandcontrolofanorovirusoutbreakinapediatrictertiarycarecenter
AT mailmantim 1261utilityofamultiplexmoleculargastrointestinalpanelinrapididentificationandcontrolofanorovirusoutbreakinapediatrictertiarycarecenter