title: [Nosocomial transmission of hepatitis C virus in a Dutch dialysis center].
abstract: OBJECTIVE
  To describe the transmission of hepatitis C virus (HCV) in a dialysis centre in the Netherlands, to analyse risk factors and to redefine additional preventive measures.
  
  
  METHODS
  Descriptive.
  
  
  METHODS
  The data of patients attending the dialysis centre of the Deventer Hospital, the Netherlands, who had participated in a national prospective survey on the epidemiology of HCV among Dutch dialysis patients, were examined. In addition, patients who developed signs of hepatic failure in the ensuing year were included in this study. To diagnose an HCV-infection serology as well as polymerase chain reaction were used. Genotyping and sequence analysis were used to assess phylogenetic relations. Infection control practices were audited.
  
  
  RESULTS
  In the dialysis centre a cluster of four almost identical HCV isolates genotype 2a was found. Within a period of one year another cluster of four HCV-infected dialysis patients was detected in the same centre. These four isolates were almost identical to a fifth isolate, genotype 2b, found in the earlier study from another patient dialysing in the same unit. It was observed that possibly contaminating procedures were not strictly separated. Some of the shared medical equipment was not sterilised but only cleaned. Also blood-contaminated gloves might have played a role in the transmission of HCV.
  
  
  CONCLUSIONS
  Nosocomial transmission plays an important role in the epidemiology of HCV in dialysis patients. Shared medical equipment and blood-contaminated gloves may constitute a potential route of transmission. There is a need for stringent implementation and regular auditing of infection control measures.
authors.affiliation: Bosch Medicentrum, afd. Medische Microbiologie, 's-Hertogenbosch.
authors.forename: P M
authors.initials: PM
authors.lastname: Schneeberger
authors.forename: C J
authors.initials: CJ
authors.lastname: Doorenbos
authors.forename: W
authors.initials: W
authors.lastname: van der Vliet
authors.forename: P
authors.initials: P
authors.lastname: Bergervoet
authors.forename: W
authors.initials: W
authors.lastname: Quint
authors.forename: L J
authors.initials: LJ
authors.lastname: van Doorn
mesh_terms: D016000:Cluster Analysis; D003428:Cross Infection / Q000517:prevention & control / Q000635:transmission*; D018562:Disease Transmission, Infectious / Q000517:prevention & control*; D004864:Equipment and Supplies / Q000592:standards; D005260:Female; D005838:Genotype; D017575:Gloves, Protective / Q000592:standards; D006436:Hemodialysis Units, Hospital / Q000592:standards*; D016174:Hepacivirus / Q000235:genetics / Q000302:isolation & purification; D006526:Hepatitis C / Q000453:epidemiology / Q000517:prevention & control / Q000635:transmission*; D006801:Humans; D017053:Infection Control / Q000592:standards; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D016133:Polymerase Chain Reaction; D012307:Risk Factors