A large nosocomial outbreak of hepatitis C and hepatitis B among patients receiving pain remediation treatments.
| Autor: | Comstock RD; Oklahoma State Department of Health, Oklahoma City, Oklahoma 73117, USA., Mallonee S, Fox JL, Moolenaar RL, Vogt TM, Perz JF, Bell BP, Crutcher JM |
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| Jazyk: | angličtina |
| Zdroj: | Infection control and hospital epidemiology [Infect Control Hosp Epidemiol] 2004 Jul; Vol. 25 (7), pp. 576-83. |
| DOI: | 10.1086/502442 |
| Abstrakt: | Background and Objective: In August 2002, the Oklahoma State Department of Health received a report of six patients with unexplained hepatitis C virus (HCV) infection treated in the same pain remediation clinic. We investigated the outbreak's extent and etiology. Design, Setting, and Participants: We conducted a retrospective cohort study of clinic patients, including a serologic survey, interviews of infected patients, and reviews of medical records and staff infection control practices. Patients received outpatient pain remediation treatments one afternoon a week in a clinic within a hospital. Cases were defined as HCV or hepatitis B virus (HBV) infections among patients who reported no prior diagnosis or risk factors for disease or reported previous risk factors but had evidence of acute infection. Results: Of 908 patients, 795 (87.6%) were tested, and 71 HCV-infected patients (8.9%) and 31 HBV-infected patients (3.9%) met the case definition. Multiple HCV genotypes were identified. Significantly higher HCV infection rates were found among individuals treated after an HCV-infected patient during the same visit (adjusted odds ratio [AOR], 6.2; 95% confidence interval [CI95], 2.4-15.8); a similar association was observed for HBV (AOR, 2.9; CI95, 1.3-6.5). Review of staff practices revealed the nurse anesthetist had been using the same syringe-needle to sequentially administer sedation medications to every treated patient each clinic day. Conclusions: Reuse of needles-syringes was the mechanism for patient-to-patient transmission of HCV and HBV in this large nosocomial outbreak. Further education and stricter oversight of infection control practices may prevent future outbreaks. |
| Databáze: | MEDLINE |
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