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Nosocomial transmission of hepatitis C virus during contrast-enhanced computed tomography scanning

Quer, Josepa b f; Esteban, Juan-Ignacioa b f; Sánchez, Josep-Mariab c; Otero, Teresaa; Rius, Cristinad; Coll, Mara b; Cubero, Mariaa b f; Moreno, Ginae; Gonzalez, Antonioa b; Vaque, Josepb c; Esteban, Rafaela b; Campins, Magdab c; Pañella, Helenad; Guardia, Jaumea b f; Martell, Mariaa

European Journal of Gastroenterology & Hepatology: January 2008 - Volume 20 - Issue 1 - p 73-78
doi: 10.1097/MEG.0b013e32825b07b0
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We have investigated two cases of acute hepatitis C that occurred in patients who underwent digestive endoscopy and contrast-enhanced computed tomography (CT) scanning at two different centers. Investigations to identify the sources of infection included an on-site review of diagnostic procedures, interview of the involved healthcare staff, serological testing of the patients who underwent the procedures before and after the index cases and a molecular analysis of viral isolates from the patients and from potential viremic sources. In both cases, the epidemiological investigation identified a chronic hepatitis C virus (HCV) carrier who had been subjected to CT-scanning immediately before the index patient. Genetic distance and molecular phylogenetic analyzes of HCV sequences showed a close relationship between the isolates from these carriers and those from the acute-hepatitis patients, strongly suggesting that patient-to-patient transmission had occurred during CT. This is the first report describing two well documented cases of HCV nosocomial patient-to-patient transmission during contrast-enhanced CT scanning.

aLiver Unit, Department of Medicine, Hospital Vall d'Hebron

bAutonomous University of Barcelona

cDepartment of Preventive Medicine and Epidemiology, Hospital Universitari Vall d'Hebron

dEpidemiological Service, Public Health Agency of Barcelona

eGeneral Subdirectorate for Evaluation and Inspection of Health Care, Department of Health, Generalitat of Catalonia

fCiberehd, Barcelona, Spain

Correspondence to Juan-Ignacio Esteban, Liver Unit, Hospital Vall d'Hebron, Pg Vall d'Hebron 119-129, 08035 Barcelona, Spain

Tel: +34 932746561/34 934894028; fax: +34 934896068;

e-mail: jiesteban@vhebron.net

Received 10 January 2007 Accepted 2 May 2007

© 2008 Lippincott Williams & Wilkins, Inc.