Current status of healthcare-associated enteroviral (non-polio) infections

Cover Page

Cite item

Abstract

Here we present the data on foreign research publications describing healthcare-associated enteroviral (nonpolio) infections (HAI) sought in the Worldwide Database for Nosocomial Outbreaks (Institut für Hygiene und Umweltmedizin, Universitȁtmedizincomplex “Charite”, Germany) as well as PubMed search engine (The United States National Library), covering 1936–2017 timeframe. The publications retrieved contained the data on 28 nosocomial outbreaks caused by Enterovirus A (EV-A71), В (Echoviruses 11, 17, 18, 30, 31, 33, Coxsackie viruses А9, В2, В5) and D (EV-D68). It was discovered that the majority of the nosocomial enteroviral (non-polio) outbreaks occurred in obstetric hospitals and neonatal units so that children were mainly maternally infected. In addition, a case associated with intrauterine infection was described. It was shown that outbreaks might be started by an infected child at the incubation period. Single publications reported nosocomial outbreaks in geriatric hospitals. Generally, nosocomial enteroviral (non-polio) outbreaks were characterized by polymorphic clinical picture caused by any certain pathogen serotype and within a single site of the infection. Few lethal outcomes were recorded. Enterovirus B species dominated among identified etiological agents. Violated hospital hygiene and infection control contributing to spread of infection were among those found in neonatal units: putting used diapers out on baby bed prior disposal, sharing bathtub, toys and household objects as well as poor hand hygiene in medical workers. One of the measures recommended to improve diagnostics of enteroviral (non-polio) infections was virology screening of children with suspected sepsis in case of unidentified etiology. It was established that etiological decoding of nosocomial outbreaks was impossible without applying pathogen-specific diagnostic tools, mainly nested RT-PCR and direct sequencing of followed by subsequent phylogenetic analysis.

About the authors

A. V. Alimov

Yekaterinburg Research Institute of Viral Infections

Email: virus@eniivi.ru

PhD (Medicine), Director

Yekaterinburg

Russian Federation

E. P. Igonina

Federal Service for Supervision on Consumer Rights and Human Wellbeing

Email: igonina_ep@gsen.ru

PhD (Medicine), Deputy Head of Department for Surveillance on Infectious and Parasitic Diseases, Administration of Epidemiological Surveillance

Moscow

Russian Federation

I. V. Feldblyum

Perm State Medical University named after academician E.A. Wagner

Email: epidperm@mail.ru

PhD, MD (Medicine), Professor, Head of Epidemiology Department of Continuing Professional Education Faculty with a Course in Hygiene and Epidemiology

Perm

Russian Federation

V. I. Chalapa

Yekaterinburg Research Institute of Viral Infections

Email: neekewa@yandex.ru
ORCID iD: 0000-0001-5823-5257
http://eniivi.ru

Researcher, Research Methodology Department,

Yekaterinburg

Russian Federation

Yu. A. Zakharova

Yekaterinburg Research Institute of Viral Infections

Author for correspondence.
Email: z.y.alexandrovna@mail.ru

Zakharova Yulia A., PhD, MD (Medicine), Associate Professor, Lead Researcher, Head of the Department for Epidemiology of Viral Infections

620030, Yekaterinburg, Letnyaya str., 23

Russian Federation

References

  1. Королева Г.А., Гульман Л.А., Лашкевич В.А., Лукашенко З.С., Шибанова Л.К. Вирус ECHO 11 — возбудитель третьей вспышки увеита у детей в г. Красноярске (1986) // Вопросы вирусологии. 1986. Т. 34, № 1. С. 55–65.
  2. Лашкевич В.А., Королева А.Г., Лукашев А.Н., Денисова Е.В., Катаргина Л.А., Хорошилова-Маслова Л.П. Острый энтеровирусный увеит у детей раннего возраста // Вопросы вирусологии. 2005. Т. 50, № 3. С. 36–45.
  3. Лашкевич В.А., Уманская С.В., Королева Г.А., Змейкова Т.Г., Базыль В.А., Катаргина Л.А., Архангельская Е.И., Хорошилова-Маслова Л.П., Скубенко С.Ф. Вспышка энтеровирусного увеита у детей в Омске в 1987–1988 гг // Вопросы вирусологии. 1990. Т. 35, № 1. С. 33–38.
  4. Apisarnthanarak A., Kitphati R., Pongsuwann Y., Tacharoenmueng R., Mundy L.M. Echovirus type 11: outbreak of hand-footand-mouth disease in a Thai hospital nursery. Clin. Infect. Dis., 2005, vol. 41, no. 9, pp. 1361–1362. doi: 10.1086/497076
  5. Bailly J.L., Béguet A., Chambon M., Henquell C., Peigue-Lafeuille H. Nosocomial transmission of echovirus 30: molecular evidence by phylogenetic analysis of the VP1 encoding sequence. J. Clin. Microbiol., 2000, vol. 38, no. 8, pp. 2889–2892.
  6. Bal A., Schuffenecker I., Casalegno J.S., Josset L., Valette M., Armand N., Dhondt P.B., Escuret V., Lina B. Enterovirus D68 nosocomial outbreak in elderly people, France, 2014. Clin. Microbiol. Infect., 2015, vol. 21, no. 8: e61–e62. doi: 10.1016/j.cmi.2015.05.008
  7. Brightman V.J., Scott T.F., Westphal M., Boggs T.R. An outbreak of coxsackie B-5 virus infection in a newborn nursery. J. Pediatr., 1966, vol. 69, no. 2, pp. 179–192.
  8. Cerny E., Kind C., Bächi T. Nosocomial epidemic of echovirus type 7 in a neonatology department. Helv. Paediatr. Acta., 1983, vol. 38, no. 5–6, pp. 457–465. (In German).
  9. Chambon M., Bailly J.L., Béguet A., Henquell C., Archimbaud C., Gaulme J., Labbé A., Malpuech G., Peigue-Lafeuille H. An outbreak due to echovirus type 30 in a neonatal unit in France in 1997: usefulness of PCR diagnosis. J. Hosp. Infect., 1999, vol. 43, no. 1, pp. 63–68.
  10. Chen J.H., Chiu N.C., Chang J.H., Huang F.Y., Wu K.B., Lin T.L. A neonatal echovirus 11 outbreak in an obstetric clinic. J. Microbiol. Immunol. Infect., 2005, vol. 38, no. 5, pp. 332–337.
  11. Cramblett H.G., Haynes R.E., Azimi P.H., Hilty M.D., Wilder M.H. Nosocomial infection with Echovirus type 11 in handicapped and premature infants. Pediatrics, 1973, vol. 51, no. 4, pp. 603–607.
  12. Daboval T., Ferretti E., Duperval R. High C-reactive protein levels during a benign neonatal outbreak of echovirus type 7. Am. J. Perinatol., 2006, vol. 23, no. 5, pp. 299–304. doi: 10.1055/s-2006-947157
  13. Eisenhut M., Algawi B., Wreghitt T., Foweraker J., McKee T., Miles R., Challener J. Fatal Coxsackie A9 virus infection during an outbreak in a neonatal unit. J. Infect., 2000, vol. 40, no. 3, pp. 297–298. doi: 10.1053/jinf.2000.0650
  14. Enterovirus. URL: http://www.picornaviridae.com/enterovirus/enterovirus.htm (30.05.2018)
  15. Farcy C., Mirand A., Marque Juillet S., Henquell C., Neulier C., Foucaud P., Peigue-Lafeuille H. Enterovirus nosocomial infections in a neonatal care unit: from diagnosis to evidence, from a clinical observation of a central nervous system infection. Arch. Pediatr., 2012, vol. 19, no. 9, pp. 921–926. doi: 10.1016/j.arcped.2012.06.015
  16. Hasegawa A. Virologic and serologic studies on an outbreak of echovirus type 11 infection in a hospital maternity unit. Jpn. J. Med. Sci. Biol., 1975, vol. 28, no. 3, pp. 179–188.
  17. Huang F.L., Chen C.H., Huang S.K., Chen P.Y. An outbreak of enterovirus 71 in a nursery. Scand. J. Infect. Dis., 2010, vol. 42, no. 8, pp. 609–612. doi: 10.3109/00365541003754444
  18. Jankovic B., Pasic S., Kanjuh B., Bukumirovic K., Cvetanovic G., Todorovic N., Djuricic S. Severe neonatal echovirus 17 infection during a nursery outbreak. Pediatr. Infect. Dis. J., 1999, vol. 18, no. 4, pp. 393–394.
  19. Kusuhara K., Saito M., Sasaki Y., Hikino S., Taguchi T., Suita S., Hayashi J., Wakatsuki K., Hara T. An echovirus type 18 outbreak in a neonatal intensive care unit. Eur. J. Pediatr., 2008, vol. 167, no. 5, pp. 587–589. doi: 10.1007/s00431-007-0516-x
  20. Lukashev A.N., Lashkevich V.A., Koroleva G.A., Ilonen J., Karganova G.G., Reznik V.I., Hinkkanen A.E. Molecular epidemiology of enteroviruses causing uveitis and multisystem hemorrhagic disease of infants. Virology, 2003, vol. 307, no. 1, pp. 45–53.
  21. Matsumoto K., Kobayashi T., Kimura Y. Isolation and preliminary characterization of antigenic variant of echovirus type 11. J. Med. Virol., 1990, vol. 31, no. 4, pp. 253–258.
  22. McDonald L.L., Geme J.W. Jr., Arnold B.H. Nosocomial infection with ECHO virus type 31 in a neonatal intensive care unit. Pediatrics, 1971, vol. 47, no. 6, pp. 995–999.
  23. Mertens T., Hager H., Eggers H.J. Epidemiology of an outbreak in a maternity unit of infections with an antigenic variant of Echovirus 11. J. Med. Virol., 1982, vol. 9, no. 2, pp. 81–91.
  24. Rabkin C.S., Telzak E.E., Ho M.S., Goldstein J., Bolton Y., Pallansch M., Anderson L., Kilchevsky E., Solomon S., Martone W.J. Outbreak of echovirus 11 infection in hospitalized neonates. Pediatr. Infect. Dis. J., 1988, vol. 7, no. 3, pp. 186–190.
  25. Sato K., Yamashita T., Sakae K., Suzuki Y., Ishikawa N., Nishimura Y. A newborn baby outbreak of echovirus type 33 infection. J. Infect., 1998, vol. 37, no. 2, pp. 123–126. doi: 10.1016/S0163-4453(98)80165-5
  26. Steinmann J., Albrecht K. Echovirus 11 outbreak among premature newborn infants in a neonatal intensive care unit. Zentralbl. Bakteriol. Mikrobiol. Hyg. A, 1985, vol. 259, no. 2, pp. 284–293. [In German].
  27. Syriopoulou V.P., Hadjichristodoulou Ch., Daikos G.L., Pirounaki M., Chatzicou V., Pavlopoulou I., Anagnostakou M., Theodoridou M., Dellagrammaticas H. Clinical and epidemiological aspects of an enterovirus outbreak in a neonatal unit. J. Hosp. Infect., 2002, vol. 51, no. 4, pp. 275–280. doi: 10.1053/jhin.2002.1253
  28. Takami T., Kawashima H., Takei Y., Miyajima T., Mori T., Nakayama T., Takekuma K., Hoshika A. Usefulness of nested PCR and sequence analysis in a nosocomial outbreak of neonatal enterovirus infection. J. Clin. Virol., 1998, vol. 11, no. 1, pp. 67–75. doi: 10.1016/S0928-0197(98)00022-1
  29. Wilson C.W., Stevenson D.K., Arvin A.M. A concurrent epidemic of respiratory syncytial virus and echovirus 7 infections in an intensive care nursery. Pediatr. Infect. Dis. J., 1989, vol. 8, no. 1, pp. 24–29.
  30. Worldwide Database for Nosocomial Outbreaks. URL: https://www.outbreak-database.com/About.aspx (27.05.2018)
  31. Zell R., Delwart E., Gorbalenya A.E., Hovi T., King A.M.Q., Knowles N.J., Lindberg A.M., Pallansch M.A., Palmenberg A.C., Reuter G., Simmonds P., Skern T., Stanway G., Yamashita T., Ictv Report Consortium. ICTV virus taxonomy profile: Picornaviridae. J. Gen. Virol., 2017, vol. 98, no. 10, pp. 2421–2422. doi: 10.1099/jgv.0.000911

Copyright (c) 2020 Alimov A.V., Igonina E.P., Feldblyum I.V., Chalapa V.I., Zakharova Y.A.

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies