Patient-to-Patient Transmission of Hepatitis C Virus during Colonoscopy

Bronowicki, Jean–Pierre; Venard, Véronique; Botte, C.; Monhoven, Nathalie; Gastin, Isabelle; Choné, Laurence; Hudziak, Hervé; Rhin, Bertrand; Delanoë, Christophe; Lefaou, Alain; Bigard, Marc‐André; Gaucher, P

doi:10.1056/nejm199707243370404

Cited by 411 publications

(190 citation statements)

References 19 publications

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“…1,2 Transmission of HCV has been reported in individual cases related to diagnostic and therapeutic procedures, as well as in circumscribed epidemics resulting from unsafe injection practices or contaminated equipment. [3][4][5][6] Transmission of HCV by an infected health care worker is a very rare event and has been essentially linked to surgery or medical care. 7,8 Although health care-related procedures have not been unequivocally associated with HCV acquisition in case-control studies, 2 some studies have demonstrated a higher prevalence of HCV infection in patients who underwent invasive medical procedures or prolonged hospitalization.…”

mentioning

confidence: 99%

Nosocomial transmission of HCV in the liver unit of a tertiary care center

et al. 2005

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Despite its medical and legal implications, there are no prospective studies analyzing the incidence and mechanisms involved in the nosocomial transmission of hepatitis C virus (HCV) in liver units. This study prospectively investigates the nosocomial transmission of HCV in the liver unit of a tertiary care center from August 2000 to October 2002. The median prevalence of HCV infection among hospitalized patients was 50%. Anti-HCVnegative patients admitted to the liver unit during the study period were prospectively followed, and serum markers of HCV infection were repeated 6 months after discharge.

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confidence: 99%

Nosocomial transmission of HCV in the liver unit of a tertiary care center

et al. 2005

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“…Microorganisms present in the colon such as Pseudomonas, Helicobacter pylori, Salmonella, Hepatitis B and C, and others have been hold responsible for endoscopy-related infections (14)(15)(16)(17). Another interesting question is whether endoscopy could be responsible for in-hospital spread of Norwalk-virus gastroenteritis.…”

Section: Discussionmentioning

confidence: 99%

Air Suctioning During Colon Biopsy Acquisition Reduces Bacterial Contamination

Vavricka¹,

Imhof²,

Wildi³

et al. 2006

Gastrointestinal Endoscopy

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Background and Aim: Contamination of endoscopy suites with bacteria during procedures is of concern particularly through droplets during handling of biopsy specimens. It has been advocated that suctioning while removing the biopsy forceps could help to reduce potentially hazardous bioaerosols. The aim of the present study was to evaluate the efficacy of air suctioning during removal of the biopsy forceps. Materials and Methods: Airborne bacteria were collected by an impactor air-sampler (MAS-100). Fifty liters of air were collected continuously for 30 seconds at a 30 cm distance from the colonoscope suction channel. Room air samples were taken in the endoscopy suite in the morning prior to the beginning of the endoscopy program, during colonoscopy with a sham biopsy in the descending colon with and without suctioning and at the end of the procedure day. Standard 90 mm Petri dishes containing a selective medium for gram-positive cocci (CNA blood agar) were used with the impaction sampler and colony forming units/m3 (cfu) were determined. Results: Measurements were performed at fifty consecutive colonoscopies. Prior to the beginning of the endoscopy program, the bioaerosol burden in the colonoscopy suite reached a mean of 4.2 cfu/m3. During colonoscopies performed without suctioning at biopsy the bioaerosol burden increased to 29.4 cfu/m3 whereas this burden increased only to 15.1 cfu/m3 when the suctioning was applied during removal of the biopsy forceps. The difference in bioaerosol burden between suctioning and no suctioning was highly significant (p < 0.0005). At the end of the procedure day the airborne bacteria count dropped to 15.6 cfu/m3. The analysis of the colonies on the CNA blood agar identified predominantly enterococci. Staphylococci spp. and other gram-positive bacteria were rarely isolated. Conclusion: The present study indicates that the bioaerosol burden during handling of biopsy specimens is not neglectable but can be reduced by the simple habit of applying suctioning during acquisition of biopsies. This practice might be an important infection-control measure during gastrointestinal endoscopies. Air Suctioning During Colon Abstract (Word count 245)Background and Aim: Contamination of endoscopy suites with bacteria during procedures is of concern. It has been advocated that suctioning while removing biopsy forceps could help to reduce hazardous bioaerosols. The aim of the present study was to evaluate the efficacy of air suctioning during removal of biopsy forceps. Materials and Methods:During colonoscopy endoscopists were asked to remove the biopsy forceps with and without suction after having touched the sigmoid mucosa.Fifty litres of air were collected continuously for 30 seconds at 30 cm distance from the colonoscope suction channel. Airborne bacteria were collected by an impactor air-sampler (MAS-100). Standard 90 mm Petri dishes with CNA blood agar were used to culture gram positive cocci. Room measurements prior to the first endoscopy and after the last endoscopy of the day were ...

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“…Fertôzött vérátömlesztés, vérkészítmények, nem steril tûszúrás közvetítésével. Illegális droghasználat, egészségügyi dolgozók véletlen tû-szúrásos balesete, invazív orvosi beavatkozás során törté-nik a vírus átvitele, míg a családi fertôzés ritka, megköze-lítôleg 1% (10,15,16). A szexuális átvitel függ a szexuá-lis szokásoktól.…”

Section: A Fertôzés Terjedéseunclassified

“…A vírus okozta krónikus antigen stimuláció a monoclonalis és polyclonalis autoantitestek felszaporodását, a humoralis immunrendszer fokozott mûkö-dését eredményezi. A legtöbb esetben a betegség patogenezisének részletei bizonytalanok maradnak (15)(16)(17)(18)(19)23).…”

Section: Extrahepatikus Manifesztációkunclassified

Hepatitis C – related diseases

Podányi¹

2013

BVSZ

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A hepatitis C kórokozója a Flavivirus családba tartozó RNA vírus mely az akut és krónikus hepatitisben jelentôs kóroki tényezô. A fertôzés, miközben a legtöbb esetben tü-netmentesen zajlik, mintegy 75%-ban krónikus hepatitist eredményez és az esetek 20-30%-ában súlyos szövôdmé-nyekhez vezet.A Key words: chronic hepatitis C -immunpathologic manifestations -extrahepatic manifestations cryoglobulinemia-skin diseases -therapyChoo és munkatársai 1989-es felfedezését követôen kiderült, hogy a korábban poszttranszfúziós, vagy sporadikus non-A, non-B hepatitis kóroki tényezôje egy C ví-rusnak elnevezett, Flavivírus családba tartozó RNS ágens (1, 2, 3). A kutatások során a hepatitis C vírusnak (HCV) 6 fô genotípusa és számos altípusa vált ismertté.Az egyes genotípusok földrajzi megoszlása eltérô, a domináló genotípus Európában az 1b, melynek a kezelés szempontjából van jelentôsége, mivel kevésbé reagál a hozzáférhetô specifikus terápiára (4,5,6).A vírusreplikáció során elôforduló spontán mutációk magas száma tette lehetôvé, hogy a HCV világszerte elterjedjen. A HCV genom variabilitása, nagy mutációs rá-tája azt eredményezi, hogy az akut infekció során a folyamat kiszabadul az immunválasz alól és a betegség nagy százalékban krónikussá válik. A replikáció során kialakult mutációk következtében számos vírusvariáns jön létre, az úgynevezett quasi-speciesek. A major és minor szubpopulációk egyensúlya az úgynevezett quasispecies distribució, melynek a patogenitásban és a folyamat krónikussá válásában fô szerepe van, éppúgy, mint a HIV vírus eseté-ben. Ez a magyarázata annak, hogy nem fejlôdik ki védô-67

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Patient-to-Patient Transmission of Hepatitis C Virus during Colonoscopy

Cited by 411 publications

References 19 publications

Nosocomial transmission of HCV in the liver unit of a tertiary care center

Nosocomial transmission of HCV in the liver unit of a tertiary care center

Air Suctioning During Colon Biopsy Acquisition Reduces Bacterial Contamination

Hepatitis C – related diseases

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