Improper Anesthesia Practice Causes Hepatitis Outbreak

Anesthesiologist reused contaminated single-use propofol vial on multiple patients
By Jeff Muise
HealthDay Reporter

FRIDAY, July 9 (HealthDay News) -- An anesthesiologist who reused a contaminated single-use propofol vial on multiple endoscopy patients caused an outbreak of hepatitis infection affecting 13 patients at two clinics, according to a report published in the July issue of Gastroenterology.

Bruce Gutelius, M.D., of the U.S. Centers for Disease Control and Prevention in Atlanta, and colleagues investigated outbreaks of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections among patients at the two clinics who had received anesthesia from the same anesthesiologist. The investigators reviewed medical charts, conducted patient interviews and site visits, and performed infection control assessments. The investigators also did molecular sequencing of available patient isolates.

At one clinic, the researchers identified six cases of HCV infection and six cases of HBV infection, and at the other clinic, one case of HCV infection; all the cases were associated with the outbreak. HCV quasispecies sequences from the patients were found to be nearly identical (96.9 to 100 percent) to those from the patients considered to be the infection source. The investigators write that the anesthesiologist used a single-use vial of propofol on multiple patients, and conclude that the likely cause of the viral transmission was the reuse of syringes to redose patients, which contaminated the vials for later patients.

"Gastroenterologists are urged to review carefully the injection, medication handling, and other infection control practices of all staff under their supervision, including providers of anesthesia services," the authors write.

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