Determinant Roles of Environmental Contamination and Noncompliance with Standard Precautions in the Risk of Hepatitis C Virus Transmission in a Hemodialysis Unit
| Autor: | Djamel Dahmanne, Martine André, Dominique Challine, Florence Cizeau, Emmanuelle Girou, Michaël Thiessart, Philippe Lang, Stéphane Chevaliez, Yoann Morice, Jean-Michel Pawlotsky, Celine Cavin, Sophan Soing-Altrach, Latifa Tkoub-Scheirlinck, Philippe Lesprit |
|---|---|
| Rok vydání: | 2008 |
| Předmět: |
Microbiology (medical)
medicine.medical_specialty Genotype medicine.medical_treatment media_common.quotation_subject Hepatitis C virus Environmental pollution Hepacivirus medicine.disease_cause Hospitals University Hygiene Internal medicine Environmental Microbiology medicine Humans Prospective Studies Seroconversion Risk factor Prospective cohort study Phylogeny media_common Cross Infection business.industry Hepatitis C Confidence interval Surgery Hemodialysis Units Hospital Infectious Diseases RNA Viral France Guideline Adherence Hemodialysis Gloves Protective business Hand Disinfection |
| Zdroj: | Clinical Infectious Diseases. 47:627-633 |
| ISSN: | 1537-6591 1058-4838 |
| DOI: | 10.1086/590564 |
| Popis: | Background Nosocomial transmission is the second most frequent cause of hepatitis C virus (HCV) infection. A prospective observational study was conducted to assess the roles of environmental contamination and noncompliance with standard precautions in HCV cross-transmission in a hemodialysis unit. Methods Patients undergoing chronic hemodialysis in a French university hospital unit were systematically screened, revealing 2 sporadic cases of HCV transmission. An investigation was launched to determine whether the patients were infected in the hemodialysis unit and the possible roles of environmental contamination and noncompliance with standard precautions. We examined possible relationships among new cases of HCV infection, environmental contamination by blood and HCV RNA, and compliance with guidelines on hand hygiene and glove use. Results Two patients experienced seroconversion to HCV during the study period. Phylogenetic analyses showed that 1 of these patients was infected with the same strain as that affecting a chronically infected patient also treated in the unit. Of 740 environmental surface samples, 82 (11%) contained hemoglobin; 6 (7%) of those contained HCV RNA. The rate of compliance with hand hygiene was 37% (95% confidence interval, 35%-39%), and gloves were immediately removed after patient care in 33% (95% confidence interval, 29%-37%) of cases. A low ratio of nurses to patients and poor hand hygiene were independent predictors of the presence of hemoglobin on environmental surfaces. Conclusion Blood-contaminated surfaces may be a source of HCV cross-transmission in a hemodialysis unit. Strict compliance with hand hygiene and glove use and strict organization of care procedures are needed to reduce the risk of HCV cross-transmission among patients undergoing hemodialysis. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|