title: A phylogenetic-tree analysis elucidating nosocomial transmission of hepatitis C virus in a haemodialysis unit.
abstract: Nosocomial transmission of hepatitis C virus (HCV) subtype 1b involving 11 haemodialysis patients occurred in a haemodialysis unit in Japan in March 2000. Sequencing of the HCV-E1 region (411-bp) and phylogenetic-tree analysis showed near identity between HCV isolates derived from these patients and a haemodialysis patient who was known to be HCV-positive. The mode of transmission could not be conclusively established, but retrospective analysis suggested that the sharing of contaminated multidose vials of heparin-saline solutions, which were prepared in the Haemodialysis Center using accidentally contaminated instruments such as needles, may have been responsible for the outbreak. To prevent transmission of HCV in a haemodialysis unit, it may be important to observe strictly standard precautions and to prepare all medications in the Pharmacy. After these measures were taken, no new seroconversions and no new nosocomial transmissions of HCV have been observed in our haemodialysis unit.
authors.affiliation: Seirei Hamamatsu General Hospital, Hamamatsu University School of Medicine, Hamamatsu, Japan. horiihm@hama-med.ac.jp
authors.forename: S
authors.initials: S
authors.lastname: Kokubo
authors.forename: T
authors.initials: T
authors.lastname: Horii
authors.forename: O
authors.initials: O
authors.lastname: Yonekawa
authors.forename: N
authors.initials: N
authors.lastname: Ozawa
authors.forename: M
authors.initials: M
authors.lastname: Mukaide
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003428:Cross Infection / Q000635:transmission* / Q000821:virology; D005260:Female; D006436:Hemodialysis Units, Hospital; D016174:Hepacivirus / Q000145:classification / Q000235:genetics* / Q000302:isolation & purification; D006526:Hepatitis C / Q000635:transmission* / Q000821:virology; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D010802:Phylogeny; D016133:Polymerase Chain Reaction; D006435:Renal Dialysis / Q000009:adverse effects; D017422:Sequence Analysis, DNA; D015678:Viral Structural Proteins / Q000235:genetics
chemical_list: D015678:Viral Structural Proteins; C107842:protein E1, Classical swine fever virus