Hepatitis B outbreak associated with a hematology-oncology office practice in New Jersey, 2009
| Autor: | Lilia Ganova-Raeva, Elizabeth F. Handschur, Corwin Robertson, Shereen Semple, Jennifer E. Crawford, Barbara Montana, Christina Tan, Patricia High, Guo-liang Xia, Rebecca Greeley, Ellen Rudowski, Nicola D. Thompson |
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| Rok vydání: | 2011 |
| Předmět: |
Adult
Male Hepatitis B virus medicine.medical_specialty Epidemiology media_common.quotation_subject Medical Oncology Disease Outbreaks Injections Hygiene Health care Blood-Borne Pathogens medicine Humans Infection control Phylogeny Aged media_common Aged 80 and over Cross Infection Infection Control Office practice New Jersey Transmission (medicine) business.industry Health Policy Public health Public Health Environmental and Occupational Health Outbreak Hematology Sequence Analysis DNA Middle Aged Hepatitis B medicine.disease Physicians' Offices Surgery Infectious Diseases Family medicine Female business |
| Zdroj: | American Journal of Infection Control. 39:663-670 |
| ISSN: | 0196-6553 |
| Popis: | Background: Transmission of bloodborne pathogens due to breaches in infection control is becoming increasingly recognized as greater emphasis is placed on reducing health care–associated infections. Two women, aged 60 and 77 years, were diagnosed with acute hepatitis B virus (HBV) infection; both received chemotherapy at the same physician’s office. Due to suspicion of health careassociated HBV transmission, a multidisciplinary team initiated an investigation of the hematology-oncology office practice. Methods: We performed an onsite inspection and environmental assessment, staff interviews, records review, and observation of staff practices. Patients who visited the office practice between January 1, 2006 and March 3, 2009 were advised to seek testing for bloodborne pathogens. Patients and medical providers were interviewed. Specimens from HBV-infected patients were sent to the Centers for Disease Control and Prevention for HBV DNA testing and phylogenic analysis. Results: Multiple breaches in infection control were identified, including deficient policies and procedures, improper hand hygiene, medication preparation in a blood processing area, common-use saline bags, and reuse of single-dose vials. The office practice was closed, and the physician’s license was suspended. Out of 2,700 patients notified, test results were available for 1,394 (51.6%). Twenty-nine outbreak-associated HBV cases were identified. Specimens from 11 case-patients demonstrated 99.9%100% nucleotide identity on phylogenetic analysis. Conclusion: Systematic breaches in infection control led to ongoing transmission of HBV infection among patients undergoing invasive procedures at the office practice. This investigation underscores the need for improved regulatory oversight of outpatient health care settings, improved infection control and injection safety education for health care providers, and the development of mechanisms for ongoing communication and cooperation among public health agencies. |
| Databáze: | OpenAIRE |
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