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E. C. Alfonso, D. Miller, P. Lawes, N. Smith, M. Diaz, E. Perez; Screening Efficacy of the RPS Adeno Detector System to Confirm Sporadic and Employee Adenoviral Conjunctivitis. Invest. Ophthalmol. Vis. Sci. 2009;50(13):5123.
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Epidemic and sporadic EKC among patients and employees occur frequently and are increasing public health concerns. Rapid detection can confirm clinical diagnosis, prevent transmission and reduce employee absenteeism. The purpose of this study was to evaluate the screening efficacy of the RPS Adeno Detector system versus both bacteria and viral cultures and clinical suspicion in patients and or employees with possible viral conjunctivitis not associated with EKC outbreaks.
The RPS Adeno Detector System (RPS) results were compared with bacterial and viral cultures to confirm the clinical suspicion of viral conjunctivitis in 33 patients and 3 employees at our institution between July-November 2008.
Twenty-two percent (8/36) of patients screened were positive with the RPS versus 11% (4/36) for viral culture. One (33%) of the three employees was confirmed with Adenovirus conjunctivitis. Agreement between viral culture and RPS was 85%, with sensitivity, specificity, PPV, NPV, 43%, 96%, 75% and 86% respectively. Bacterial infection was confirmed in a third (11/33, 33%) of the screened patients. Co-infection with Adenovirus was evident in 60% (3/8)of the RPS patients. Common bacterial pathogens included Haemophilus influenzae (15% (5/33), Staphylococcus aureus (12%, 4/33), and Streptococcus pneumoniae (3%, 1/33). Sixty (60%) of patients with confirmed viral conjunctivitis were less than 30 years of age, versus 27% for those with confirmed bacterial infections in this population.
Clinical differentiation between viral and bacterial conjunctivitis remain challenging. RPS Adeno Detector may have a role as an adjunct to clinical diagnosis in supporting or rejecting viral conjunctivitis in non outbreak settings and to confirm illnesses in susceptible employee. Bacterial cultures maybe warranted to reduce missed opportunities to treat and control nonviral conjunctivitis.
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