A Large Nosocomial Outbreak of Hepatitis C and Hepatitis B Among Patients Receiving Pain Remediation Treatments
| Autor: | Tara M. Vogt, Sue Mallonee, Joseph F. Perz, James M. Crutcher, Jan L Fox, Ronald L. Moolenaar, Beth P. Bell, R Dawn Comstock |
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| Rok vydání: | 2004 |
| Předmět: |
Adult
Male Microbiology (medical) medicine.medical_specialty Adolescent Epidemiology medicine.disease_cause Risk Assessment Disease Outbreaks Cohort Studies Internal medicine Equipment Reuse medicine Humans Infection control Aged Retrospective Studies Aged 80 and over Hepatitis B virus Cross Infection Infection Control business.industry Incidence Oklahoma Retrospective cohort study Hepatitis C Nurse anesthetist Odds ratio Middle Aged Hepatitis B medicine.disease Surgery Infectious Diseases Needles Pain Clinics Female business business.employer Cohort study |
| Zdroj: | Infection Control & Hospital Epidemiology. 25:576-583 |
| ISSN: | 1559-6834 0899-823X 0195-9417 |
| DOI: | 10.1086/502442 |
| Popis: | 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: | OpenAIRE |
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