title: Use of genome sequencing to identify hepatitis C virus transmission in a renal healthcare setting.
abstract: BACKGROUND
  Hepatitis C virus (HCV) infection is a major health burden worldwide. A patient with no history of HCV infection while on a renal unit was found to seroconvert to HCV.
  
  
  OBJECTIVE
  To report the use of sequencing to postulate how transmission of HCV occurred in a healthcare setting, and how this guided our outbreak investigation.
  
  
  RESULTS
  Based on infection control inspections the transmission event was surmised to be due to ward environmental contamination with blood and subsequent inoculation from intravenous interventions on the patient acquiring HCV. We discuss the interventions put in place in response to the outbreak investigation findings.
  
  
  CONCLUSIONS
  Sequencing of healthcare-acquired HCV infections should be undertaken as routine practice in outbreak investigations.
authors.affiliation: University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, Edgbaston, Birmingham, UK. Electronic address: mark.garvey@uhb.nhs.uk.
authors.forename: M I
authors.initials: MI
authors.lastname: Garvey
authors.affiliation: University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, Edgbaston, Birmingham, UK.
authors.forename: C W
authors.initials: CW
authors.lastname: Bradley
authors.affiliation: University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, Edgbaston, Birmingham, UK.
authors.forename: K L
authors.initials: KL
authors.lastname: Holden
authors.affiliation: University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, Edgbaston, Birmingham, UK.
authors.forename: P
authors.initials: P
authors.lastname: Hewins
authors.affiliation: Blood Borne Virus Unit, Microbiology Service Colindale, Public Health England, London, UK.
authors.forename: S-L
authors.initials: SL
authors.lastname: Ngui
authors.affiliation: Blood Borne Virus Unit, Microbiology Service Colindale, Public Health England, London, UK.
authors.forename: R
authors.initials: R
authors.lastname: Tedder
authors.affiliation: University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, Edgbaston, Birmingham, UK.
authors.forename: P
authors.initials: P
authors.lastname: Jumaa
authors.affiliation: University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, Edgbaston, Birmingham, UK; Public Health England Birmingham Laboratory, Birmingham Heartlands Hospital, Birmingham, UK.
authors.forename: E
authors.initials: E
authors.lastname: Smit
mesh_terms: D005838:Genotype; D016174:Hepacivirus / Q000145:classification* / Q000235:genetics* / Q000302:isolation & purification; D006526:Hepatitis C / Q000453:epidemiology / Q000821:virology*; D006801:Humans; D017053:Infection Control / Q000379:methods; D017720:Molecular Epidemiology / Q000379:methods*; D006435:Renal Dialysis / Q000009:adverse effects*; D000073336:Whole Genome Sequencing / Q000379:methods*
keywords: Bloodborne transmission; Hepatitis C; Infection prevention and control; NS5B genome sequencing