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Journal of Clinical Microbiology, November 2002, p. 4363-4366, Vol. 40, No. 11
0095-1137/02/$04.00+0     DOI: 10.1128/JCM.40.11.4363-4366.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.

Outbreak of Nosocomial Hepatitis C Virus Infection Resolved by Genetic Analysis of HCV RNA

Miguel Bruguera,1* Juan-Carlos Saiz,1 Sandra Franco,1 Mireia Giménez-Barcons,1 José María Sánchez-Tapias,1 Silvia Fabregas,2 Roser Vega,2 Neus Camps,3 Angela Domínguez,3 and Lluis Salleras3

Liver Unit, Institut de Malalties Digestives, Hospital Clínic,1 Departament de Sanitat i Seguretat Social, Generalitat de Catalunya, Barcelona,3 Hospital de Figueres, Girona, Spain2

Received 21 February 2002/ Returned for modification 30 June 2002/ Accepted 5 August 2002

In July 2000, symptomatic acute hepatitis C was diagnosed in five patients who had attended the emergency room of a municipal hospital on the same day, about 6 weeks before. Investigation of the remaining 65 patients visited at the emergency room on that day disclosed that 8 patients had a positive anti-hepatitis C virus (anti-HCV) test and 4 of them had biochemical evidence of acute anicteric hepatitis. HCV RNA was detected in 12 of the 13 anti-HCV-positive patients. Phylogenetic analysis of the nonstructural 5A (NS5A) and E2 regions showed that 10 patients, including all 9 with acute hepatitis, were infected with a closely related HCV strain, while the remaining 2 patients harbored unrelated strains. Flushing of intravenous catheters with heparin retrieved from a multidose heparin solution in saline was carried out for all the patients involved in the hepatitis outbreak but in only 1 of 23 (4%) matched controls recruited among HCV-noninfected patients attending the emergency room on the same day, and this was the only significant difference concerning risk factors for HCV infection between patients and controls. Thus, accidental contamination of a multidose heparin solution with blood from an unrecognized HCV carrier was identified as the source of this nosocomial outbreak of hepatitis C.

* Corresponding author. Mailing address: Unidad de Hepatología, Hospital Clínic, C/Villaroel 170, 08036, Barcelona, Spain. Phone: 34-93-227 54 99. Fax: 34-93-227 93 72. E-mail: 4625mbc{at}comb.es.

Journal of Clinical Microbiology, November 2002, p. 4363-4366, Vol. 40, No. 11
0095-1137/02/$04.00+0     DOI: 10.1128/JCM.40.11.4363-4366.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.



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