[Reducing the risk of blood-transmitted infections of HIV, hepatitis B or C virus in a teaching hospital in Amsterdam--evaluation of a protocol for needlestick accidents among hospital staff during the period 1997-2001].
OBJECTIVE
To evaluate a protocol for hospital staff aimed at reducing their risk of exposure to blood-transmitted infections.


METHODS
Prospective.


METHODS
In August 1997 a protocol was introduced to the Onze Lieve Vrouwe Gasthuis Hospital in Amsterdam, with procedures to be followed after percutaneous or mucocutaneous blood contact in which there was a chance of transmission of hepatitis B (HBV) or C (HCV), as well as guidelines for the prescription of post-exposure prophylaxis (PEP) after accidents with an HIV risk. In the period 1 August 1997-30 June 2001 data were collected from registration forms that reported accidents and the ensuing events.


RESULTS
A total of 403 accidents were reported by 138 (34.2%) physicians, 135 (33.5%) ward nurses, 46 (11.4%) operation assistants, 30 (7.4%) co-assistants, 21 (5.2%) analysts and 33 (8.2%) persons with another position. There was a constant increase in the number of reports over the period. The seroprevalence of the source patients was: 6.9% (25/360) HIV, 8.1% (6/74) HBV and 6.3% (23/363) HCV. PEP was prescribed on 46 occasions: 15 times for an HIV positive source and 31 times for what was initially an unknown HIV source. Following the introduction of a rapid HIV test in September 1999, there was a reduction in the number of unnecessary PEP prescriptions from 4 in 1997, 7 in 1998 and 16 in 1999 to 3 in 2000 and 1 in 2001. All 15 persons who were correctly started on a PEP treatment took the medication for a period of 28 days despite many side effects. No seroconversions were established during the follow-up period of 6 months.
Regez
R M
RM
Onze Lieve Vrouwe Gasthuis, locatie Oosterpark, afd. Interne Geneeskunde, Postbus 95.500, 1090 HM Amsterdam. r.m.regez@olvg.nl
Rietra
P J G M
PJ
van der Linden
C Th M
CT
Frissen
P H J
PH
Weigel
H M
HM
Brinkman
K
K
D000328:Adult; D003428:Cross Infection / Q000517:prevention & control; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000635:transmission*; D006509:Hepatitis B / Q000635:transmission*; D006526:Hepatitis C / Q000635:transmission*; D006801:Humans; D017758:Infectious Disease Transmission, Patient-to-Professional / Q000517:prevention & control*; D008297:Male; D016602:Needlestick Injuries; D009426:Netherlands; D016273:Occupational Exposure; D010564:Personnel, Hospital; D011446:Prospective Studies; D016036:Seroepidemiologic Studies