Transmission of Hepatitis B Virus to Multiple Patients from a Surgeon without Evidence of Inadequate Infection Control
| Autor: | K Kotsopoulou, J D Cherry, Rafael Harpaz, F M Averhoff, S D Sinha, S B Lambert, M P Tormey, Craig N. Shapiro, B H Robertson, L Von Seidlein |
|---|---|
| Rok vydání: | 1996 |
| Předmět: |
Adult
Male Hepatitis B virus medicine.medical_specialty HBsAg Adolescent medicine.disease_cause Disease Outbreaks Infectious Disease Transmission Professional-to-Patient Cohort Studies Risk Factors Internal medicine Medical Staff Hospital medicine Humans Infection control Child Aged Retrospective Studies Aged 80 and over Cross Infection Infection Control Hepatitis B Surface Antigens biology Transmission (medicine) business.industry Infant Internship and Residency Thoracic Surgery Retrospective cohort study General Medicine Middle Aged Hepatitis B medicine.disease biology.organism_classification United States Surgery Hepadnaviridae Child Preschool DNA Viral Heart Transplantation Female Viral disease business |
| Zdroj: | New England Journal of Medicine. 334:549-554 |
| ISSN: | 1533-4406 0028-4793 |
| Popis: | Although about 1 percent of surgeons are infected with hepatitis B virus (HBV), transmission from surgeons to patients is thought to be uncommon. In July 1992, a 47-year-old woman became ill with acute hepatitis B after undergoing a thymectomy in which a thoracic-surgery resident who had had acute hepatitis B six months earlier assisted.To determine whether the surgeon transmitted HBV to this patient and others, we conducted chart reviews, interviews, and serologic testing of thoracic-surgery patients at the two hospitals where the surgeon worked from July 1991 to July 1992. Hepatitis B surface antigen (HBsAg) subtypes and DNA sequences from the surgeon and from infected patients were determined.Of 144 susceptible patients in whose surgery the infected surgeon participated, 19 had evidence of recent HBV infection (13 percent). One of the hospitals was selected for additional study, and none of the 124 susceptible patients of the other thoracic surgeons at this hospital had evidence of recent HBV infection (relative risk, infinity; 95 percent confidence interval, 4.7 to infinity). No evidence was found for any common source of HBV other than the infected surgeon. The HBsAg subtype and the partial HBV DNA sequences from the surgeon were identical to those in the infected patients. Transmission of the infection was associated with cardiac transplantation (relative risk, 4.9; 95 percent confidence interval, 1.5 to 15.5) but not with other surgical procedures. The surgeon was positive for hepatitis B e antigen and had a high serum HBV DNA concentration (15 ng per milliliter). Our investigations identified no deficiencies in the surgeon's infection-control practices.In this outbreak there was surgeon-to-patient HBV transmission despite apparent compliance with recommended infection-control practices. We could not identify any specific events that led to transmission. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|