Nosocomial transmission of hepatitis C virus associated with the use of multidose saline vials

Infect Control Hosp Epidemiol. 2003 Feb;24(2):122-7. doi: 10.1086/502176.

Abstract

Objective: To identify the source of an outbreak of acute hepatitis C virus (HCV) infection among 3 patients occurring within 8 weeks of hospitalization in the same ward of a Florida hospital during November 1998.

Design: A retrospective cohort study was conducted among 41 patients hospitalized between November 11 and 19, 1998. Patients' blood was tested for antibodies to HCV, and HCV RNA-positive samples were genotyped and sequenced.

Results: Of the 41 patients, 24 (59%) participated in the study. HCV genotype lb infections were found in 5 patients. Three of 4 patients who received saline flushes from a multidose saline vial on November 16 had acute HCV infection, whereas none of the 9 patients who did not receive saline flushes had HCV infection (P = .01). No other significant exposures were identified. The HCV sequence was available for 1 case of acute HCV and differed by a single nucleotide (0.3%) from that of the indeterminate case.

Conclusion: This outbreak of HCV probably occurred when a multidose saline vial was contaminated with blood from an HCV-infected patient Hospitals should emphasize adherence to standard procedures to prevent blood-borne infections. In addition, the use of single-dose vials or prefilled saline syringes might further reduce the risk for nosocomial transmission of blood-borne pathogens.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Blood-Borne Pathogens
  • Catheters, Indwelling / virology
  • Child
  • Cohort Studies
  • Cross Infection / epidemiology*
  • Cross Infection / etiology
  • Cross Infection / virology*
  • Disease Outbreaks
  • Equipment Contamination*
  • Female
  • Florida
  • Genotype
  • Hepacivirus / genetics*
  • Hepacivirus / isolation & purification
  • Hepatitis C / diagnosis
  • Hepatitis C / epidemiology*
  • Hepatitis C / etiology
  • Hepatitis C Antibodies / blood
  • Hospital Units / statistics & numerical data*
  • Humans
  • Male
  • Middle Aged
  • RNA, Viral / analysis
  • Retrospective Studies
  • Reverse Transcriptase Polymerase Chain Reaction
  • Sodium Chloride
  • Syringes / virology*

Substances

  • Hepatitis C Antibodies
  • RNA, Viral
  • Sodium Chloride