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An Outbreak of Hospital-Acquired Hepatitis B Virus Infection Among Patients Receiving Chronic Hemodialysis

Published online by Cambridge University Press:  02 January 2015

Yvan J.E Hutin ,
Susan T. Goldstein ,
Jay K. Varma ,
Joan B. O'Dair ,
Eric E. Mast ,
Craig N. Shapiro  and
Miriam J. Alter
Yvan J.E Hutin
Affiliation:
Hepatitis Branch, Division of Viral and Rickettsial Diseases, National Center for Infectious Diseases, Atlanta, Georgia Epidemic Intelligence Service, Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, Georgia
Susan T. Goldstein
Affiliation:
Hepatitis Branch, Division of Viral and Rickettsial Diseases, National Center for Infectious Diseases, Atlanta, Georgia
Jay K. Varma
Affiliation:
Department of Internal Medicine, University of California, San Diego, California
Joan B. O'Dair
Affiliation:
Allegheny County Department of Public Health, Pittsburgh, Pennsylvania
Eric E. Mast
Affiliation:
Hepatitis Branch, Division of Viral and Rickettsial Diseases, National Center for Infectious Diseases, Atlanta, Georgia
Craig N. Shapiro
Affiliation:
Hepatitis Branch, Division of Viral and Rickettsial Diseases, National Center for Infectious Diseases, Atlanta, Georgia
Miriam J. Alter*
Affiliation:
Hepatitis Branch, Division of Viral and Rickettsial Diseases, National Center for Infectious Diseases, Atlanta, Georgia
*
Centers for Disease Control and Prevention, MS G37, 1600 Clifton Rd, Atlanta, GA 30333
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Abstract

Objective:

To investigate a cluster of hepatitis B virus (HBV) infections between December 1995 and May 1996 among chronic hemodialysis patients in one county.

Setting:

Two dialysis centers (A and B) and a hospital (C) in one county.

Patients:

Six case-patients who were dialyzed in one of two centers, A and B, and had all been hospitalized between January and February 1996 at hospital C.

Methods:

Patient 1, usually dialyzed in center A sero-converted to hepatitis B surface antigen (HBsAg) in December 1995 and could have been the source of infection for the others, who seroconverted between March and April 1996. Two cohort studies were conducted: one among patients dialyzed in center A to determine where transmission had occurred, and one among patients dialyzed at hospital C at the time patient 1 was hospitalized, to identify factors associated with infection.

Results:

Four (15%) of the 26 susceptible patients dialyzed at center A became infected with HBV. Hospitalization at hospital C when patient 1 was hospitalized was associated with infection (P=.002). A cohort study of the 10 susceptible patients dialyzed at hospital C during the time patient 1 was hospitalized did not identify specific risk factors for infection. However, supplies and multidose vials were shared routinely among patients, providing opportunities for transmission.

Conclusion:

When chronic hemodialysis patients require dialysis while hospitalized, their HBsAg status should be reviewed, and no instrument, supplies, or medications should be shared among them.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 20 , Issue 11 , November 1999 , pp. 731 - 735
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1999

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