Contamination by hepatitis B and C viruses in the dialysis setting.
BACKGROUND
Hepatitis virus infections continue to be a major concern in the dialysis setting. We studied levels of hepatitis B surface antigen (HBsAg) and hepatitis C virus (HCV) RNA contamination in dialysis units to better define the role of the dialysis environment and machines in the nosocomial transmission of hepatitis viruses.


METHODS
Possible contamination by hepatitis B virus (HBV) and HCV was studied by collecting environmental samples in 3 dialysis units located in Rome, Italy. Samples and controls were tested for HBsAg by a microparticle enzyme immunoassay, and for HCV RNA, by qualitative transcription-mediated amplification assay.


RESULTS
HCV RNA and HBsAg were detected in 1 of 64 (1.6%) and 1 of 64 samples (1.6%), respectively. The only HCV RNA-positive sample was found in 1 dialysis unit on the external surface of the dialysate (inlet-outlet) connector of a dialysis machine used for HCV-negative patients. The only HBsAg-positive sample was found in another dialysis unit on the internal surface of the blood pressure monitor cuff of a dialysis bed dedicated for HBsAg-positive patients.


CONCLUSIONS
A segregation policy for HBsAg-positive patients is a necessary measure despite its high cost-effectiveness; we found HBsAg contamination in the segregated HBV-infected room. Conversely, the finding of HCV RNA contamination on a dialysis machine not dedicated to HCV-positive patients suggests that isolation of HCV-infected dialysis patients and use of dedicated machines are unjustified. Major attention should be given to strict adherence to infection control measures in the dialysis setting.
Froio
Nicola
N
National Institute for Infectious Diseases, Lazzaro Spallanzani, Rome, Italy.
Nicastri
Emanuele
E
Comandini
Ubaldo Visco
UV
Cherubini
Chiara
C
Felicioni
Roberto
R
Solmone
Mariacarmela
M
Di Giulio
Salvatore
S
Petrosillo
Nicola
N
D003428:Cross Infection / Q000517:prevention & control / Q000635:transmission; D004866:Equipment Contamination; D006436:Hemodialysis Units, Hospital / Q000706:statistics & numerical data*; D016174:Hepacivirus / Q000302:isolation & purification*; D006509:Hepatitis B / Q000517:prevention & control / Q000635:transmission; D006514:Hepatitis B Surface Antigens / Q000032:analysis; D006515:Hepatitis B virus / Q000302:isolation & purification*; D006526:Hepatitis C / Q000517:prevention & control / Q000635:transmission; D006801:Humans; D017053:Infection Control / Q000592:standards; D010356:Patient Isolation; D012367:RNA, Viral / Q000032:analysis; D006435:Renal Dialysis / Q000295:instrumentation*; D012384:Rome; D019722:Sphygmomanometers
D006514:Hepatitis B Surface Antigens; D012367:RNA, Viral