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By Gary Evans, Senior Staff Writer
Healthcare facilities providing hemodialysis services should review and reinforce infection control measures, as hepatitis C virus outbreaks have resulted in 36 cases of HCV in 19 different hemodialysis clinics in eight states over the last two years, the Centers for Disease Control and Prevention reports.
“While investigations are ongoing, so far, HCV transmission between patients has been demonstrated at nine of those clinics, based on epidemiologic and viral sequencing evidence,” the CDC notes in a Jan. 27 Health Advisory alert. “Lapses in infection control (e.g., injection safety, environmental disinfection, and hand hygiene) were commonly identified at these facilities. Although the exact means of transmission could not be discerned, these lapses all could potentially contribute to HCV transmission."
Hemodialysis is the most common method used to treat kidney failure. The increase in acute HCV infections might be due in part to a surveillance artifact, as a result of improved screening and awareness of the potential for HCV infection in the hemodialysis setting.
"Regardless, this increase underscores the widespread potential for patients to acquire serious infections during dialysis care," the CDC notes. "Dialysis facilities should actively assess and continuously improve their infection control, environmental cleaning and disinfection, and HCV screening practices, whether or not they are aware of infections in their clinic."
Any case of new HCV infection in a patient undergoing hemodialysis is likely to be a healthcare-associated infection and should be reported to public health authorities in a timely manner. The CDC is urging dialysis providers and facilities to:
• Assess current infection control practices and environmental cleaning and disinfection practices within the facility to ensure adherence to infection control standards
• Address any gaps identified by the assessments
• Screen patients for HCV, following CDC guidelines, to detect infections, determine treatment potential, and halt secondary transmission
• Promptly report all acute HCV infections to the state or local health department.
For more on this story see the March 2015 issue of Hospital Infection Control & Prevention