Hostname: page-component-745bb68f8f-grxwn Total loading time: 0 Render date: 2025-01-27T17:18:56.918Z Has data issue: false hasContentIssue false
  • English
  • Français

Hepatitis C in a Ward for Cystic Fibrosis and Diabetic Patients Possible Transmission by Spring-Loaded Finger-Stick Devices for Self-Monitoring of Capillary Blood Glucose

Published online by Cambridge University Press:  02 January 2015

Jean-Claude Desenclos ,
Martine Bourdiol-Razès ,
Bernard Rolin ,
Patrick Garandeau ,
Jacques Ducos ,
Christian Bréchot  and
Valérie Thiers
Jean-Claude Desenclos*
Affiliation:
Institut de Veille Sanitaire, Saint-Maurice
Martine Bourdiol-Razès
Affiliation:
Direction Départementale de l'Herault, Montpellier
Bernard Rolin
Affiliation:
Centre Hospitaller Universitaire de Montpellier, France
Patrick Garandeau
Affiliation:
Centre Hospitaller Universitaire de Montpellier, France
Jacques Ducos
Affiliation:
Centre Hospitaller Universitaire de Montpellier, France
Christian Bréchot
Affiliation:
Laboratoire Mixte Pasteur-Necker, CNR pour l'Epidemiologie Moleculaire des Hepatites Viralies, France
Valérie Thiers
Affiliation:
Laboratoire Mixte Pasteur-Necker, CNR pour l'Epidemiologie Moleculaire des Hepatites Viralies, France
*
Institut de Veille Sanitaire, 14 rue du Val d'Osne, 94415 Saint-Maurice, Cedex, France
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

To identify the routes of transmission in a nosocomial outbreak of hepatitis C virus (HCV) infection.

Design:

Epidemiological investigation, including screening for HCV of hospitalized patients, and a retrospective cohort study, review of hygiene and medical practices, and molecular comparison of HCV isolates.

Setting:

A specialized care unit for cystic fibrosis (CF) and diabetic patients at an acute-care facility in the south of France.

Results:

Of the 57 CF patients (age in 1995: 2-28 years), 38 (66.7%) were tested and 22 (57.9%) were anti-HCV positive. Eight (50%) of 16 patients with anti-HCV antibody tested by polymerase chain reaction were viremic. No patients had received blood products or had any history of intravenous drug use. All 18 (100%) patients with CF who had ever undergone self-monitoring of capillary blood glucose in the unit were anti-HCV positive, compared to 4 (20%) of 20 who had not (relative risk, 5.0; 95% confidence interval, 2.1-12.0). Seventy (39.5%) of the patients with diabetes were screened for anti-HCV; 12 (18.8%) tested positive, with 3 (25%) positive for HCV-RNA. Patients with diabetes had routine capillary blood glucose monitoring while hospitalized and shared with CF patients the same spring-triggered devices for capillary blood glucose monitoring. The disposable platform of the devices was not changed between patient use. All HCV isolates belonged to the type 1, subtype b, and phylogenetic analysis showed a close homology by sequencing of NS5b and E2/HVR regions.

Conclusion:

As reported earlier for the hepatitis B virus, shared spring-triggered devices for capillary blood glucose monitoring by finger puncture may transmit HCV. Strict application of Standard Precautions procedures is warranted in any healthcare setting.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 22 , Issue 11 , November 2001 , pp. 701 - 707
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2001

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.MacDonald, M, Crofts, N, Kaldor, J. Transmission of hepatitis C virus: rates, routes, and cofactors. Epidemiol Rev 1996;18:137–148.CrossRefGoogle ScholarPubMed
2.Allander, T, Medin, C, Jacobson, SH, Grillner, L, Persson, MA. Hepatitis C transmission in a hemodialysis unit: molecular evidence for spread of virus among patients not sharing equipment. J Med Virol 1994;43:415–419.CrossRefGoogle Scholar
3.McLaughlin, KJ, Cameron, SO, Good, T, McCruden, E, Ferguson, JC, Davidson, F, et al.Nosocomial transmission of hepatitis C virus within a British dialysis centre. Nephrol Dial Transplant 1997;12:304–309.CrossRefGoogle ScholarPubMed
4.Stuyver, L, Claeys, H, Wyseur, A, Van Arnhem, W, De Beenhouwer, H, Uytendaele, S, et al.Hepatitis C virus in a hemodialysis unit: molecular evidence for nosocomial transmission. Kidney Int 1996;49:889–895.CrossRefGoogle Scholar
5.Forns, X, Fernandez-Llama, P, Pons, M, Costa, J, Ampurdanes, S, Lopez-Labrador, FX, et al.Incidence and risk factors of hepatitis C virus infection in a haemodialysis unit. Nephrol Dial Transplant 1997;12:736–740.Google Scholar
6.Izopet, J, Pasquier, C, Sandres, K, Puel, J, Rostaing, L. Molecular evidence for nosocomial transmission of hepatitis C virus in a French hemodialysis unit. J Med Virol 1999;58:39–44.Google Scholar
7.Allander, T, Gruber, A, Naghavi, M, Beyene, A, Soderstom, T, Bjorkholm, M, et al.Frequent patient-to-patient transmission of hepatitis C virus in a haematology ward. Lancet 1995;345:603–607.Google Scholar
8.Schvarcz, R, Johansson, B, Nyström, B, Sönnerborg, A. Nosocomial transmission of hepatitis C virus. Infection 1997;25:74–77.Google Scholar
9.Chant, K, Kociuba, K, Munro, R, Crone, S, Kerridge, R, Quin, J, et al.Investigation of possible patient-to-patient transmission of hepatitis C in a hospital. The New South Wales Public Health Bulletin 1994;5:47–51.CrossRefGoogle Scholar
10.Widell, A, Christensson, B, Wiebe, T, Schalen, C, Hansson, HB, Allander, T, et al.Epidemiologic and molecular investigation of outbreaks of hepatitis C virus infection on a pediatric oncology service. Ann Intern Med 1999;130:130–134.Google Scholar
11.Bronowicki, JP, Vénard, V, Botté, C, Monhoven, N, Gastin, I, Chone, L, et al.Patient-to-patient transmission of hepatitis C virus during colonoscopy. N Engl J Med 1997;337:237–240.Google Scholar
12.Andrieu, J, Barny, S, Colardelle, P, Maisonneuve, P, Giraud, V, Robin, E, et al.Prevalence and risk factors of hepatitis C virus infection in a hospitalized population in a gastroenterology unit: role of endoscopic biopsies. Gastroenterol Clin Biol 1995;19:340–345.Google Scholar
13.Dubois, F, Desenclos, JC, Mariotte, N, Goudeau, A. Hepatitis C in a French population-based survey, 1994: seroprevalence, frequency of viremia, genotype distribution, and risk factors. The Collaborative Study Group. Hepatology 1997;25:490–496.Google Scholar
14.Chiaramonte, M, Stroffolini, X, Lorenzoni, U, Minniti, F, Conti, S, Floreani, A, et al.Risk factors in community-acquired chronic hepatitis C virus infection: a case-control study in Italy. J Hepatol 1996;24:129–134.CrossRefGoogle ScholarPubMed
15.Ho, MS, Hsu, CP, Yuh, Y, King, CC, Xsai, JF, Mau, YC, et al.High rate of hepatitis C virus infection in an isolated community: persistent hyper-endemicity or period-related phenomena? J Med Virol 1997;52:370–376.3.0.CO;2-Z>CrossRefGoogle ScholarPubMed
16.Guadagnino, V, Stroffolini, X, Rapicetta, M, Costantino, A, Kondili, LA, Menniti-Ippolito, F, et al.Prevalence, risk factors, and genotype distribution of hepatitis C virus infection in the general population: a community-based survey in southern Italy. Hepatology 1997;26:1006–1011.CrossRefGoogle ScholarPubMed
17.Holland, PV, Barrera, JM, Ercilla, MG, Yoshida, C, Wang, Y, Olim, G, et al.Genotyping hepatitis C virus isolates from Spain, Brazil, China, and Macau by a simplified PCR method. J Clin Microbiol 1996;34:2372–2378.CrossRefGoogle ScholarPubMed
18.Lee, JH, Stripf, T, Roth, WK, Zeuzem, S. Non-isotopic detection of hepatitis C virus quasipecies by single strand conformation polymorphism. J Med Virol 1997;53:245–251.Google Scholar
19.Thompson, JD, Higgins, DG, Gibson, TJ. CLUSXAL W: improving the sensitivity of progressive multiple sequence alignment through sequence weighting, position specific gap penalties and weight matrix choice. Nucleic Acids Res 1994;22:4673–4680.CrossRefGoogle ScholarPubMed
20.Page, RD. Tree View: an application to display phylogenetic trees on personal computers. Comput Appl Biosci 1996;12:357–358.Google Scholar
21.Rothman, K, Greenland, S. Modern Epidemiology. 2nd ed. Philadelphia, PA: Lippincott-Raven Publishers; 1998.Google Scholar
22.Douvin, C, Simon, D, Zinelabidine, H, Wirquin, V, Perlemuter, L, Dhumeaux, D. An outbreak of hepatitis B in an endocrinology unit traced to a capillary-blood-sampling device. N Engl J Med 1990;322:57.Google Scholar
23.Polish, LB, Shapiro, G, Bauer, F, Klotz, P, Ginier, P, Roberto, RR, et al.Nosocomial transmission of hepatitis B virus associated with the use of a spring-loaded finger-stick device. N Engl J Med 1992;326:721–755.Google Scholar
24.Centers for Disease Control and Prevention. Nosocomial hepatitis B virus infection associated with reusable fingerstick blood sampling devices-Ohio and New York City, 1996. MMWR 1997;46:217–221.Google Scholar
25.Robert, LM, Chamberland, ME, Cleveland, JL, Marcus, R, Goach, BF, Srivastava, PU, et al.Investigations of patients of health care workers infected with HIV: the Centers for Disease Control and Prevention database. Ann Intern Med 1995;122:653–657.CrossRefGoogle Scholar
26.Lot, F, Seguier, JC, Fegueux, S, Astagneau, P, Simon, P, Aggoune, M, et al.HIV transmission from an orthopedic surgeon to a patient in France. Ann Intern Med 1999;130:1–6.Google Scholar
27.Okuda, K, Hayashi, H, Kobayashi, S, Irie, Y. Mode of hepatitis C infection not associated with blood transfusion among chronic hemodialysis patients. J Hepatol 1995;23:28–31.Google Scholar
28.Blumberg, A, Zehnder, C, Burckhardt, JJ. Prevention of hepatitis C infection in haemodialysis units: a prospective study. Nephrol Dial Transplant 1995;10:230–233.Google Scholar
29.Alfurayh, O, Sabeel, A, Al Ahdal, MN, Almeshari, K, Kessie, G, Hamid, M, et al.Hand contamination with hepatitis C virus in staff looking after hepatitis C-positive hemodialysis patients. Am J Nephrol 2000;20:103–106.Google Scholar