The present status of the hospital infection control for viral hepatitis in hemodialysis facilities

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  • Ando Ryoichi
    Department of Nephrology, Musashino Red Cross Hospital
  • Akiba Takashi
    Division of Blood Purification, Kidney Center, Tokyo Women's Medical University

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  • 血液透析施設におけるウイルス性肝炎に対する院内感染防止対策の現況
  • ケツエキ トウセキ シセツ ニ オケル ウイルスセイ カンエン ニ タイスル インナイ カンセン ボウシ タイサク ノ ゲンキョウ

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Abstract

The status of hospital infection control for viral hepatitis in dialysis facilities was investigated in 2006 and findings were compared to those obtained in 2000. We mailed questionnaires to hemodialysis facilities and recovered them from 1817 facilities (recovery rate of 50.63%). An infection control system such as an infection control commission and infection control manual was organized in a higher portion of facilities in 2006 than in 2000. The rate of bed fixation for anti-HCV antibody-positive patients was 67.3% and was higher than that in 2000. Administration of erythyropoietin in a divided dose to different patients, reuse of the used syringe, and use of leftover saline for another patient had decreased, but these practices had not been eradicated. A pre-filled syringe with erythyropoietin was used in 94.9% of facilities, but the use of pre-filled syringes for heparin was still limited to 27.1%. The HBs antigen- and anti-HCV antibody-positive rates were lower in facilities using gloves when returning blood. Information on anti-HCV antibody-positive result and the daily life consultations for anti-HCV antibody-positive patients were related to the lower anti-HCV antibody-positive rate. Image inspection of viral hepatitis patient was done periodically in 80% of facility, but medical examination by hepatologists was limited to 25.3%. Therapy for viral hepatitis was given in 39.6% of facilities, but anti-viral medical therapy with interferon was administered to fewer patients. In conclusion, infection control measures showed an improvement since 2000, but there is still considerable room for improvement. The diagnosis and treatment of viral hepatitis in dialysis patients remains insufficient. Guidelines for diagnosis and treatment of viral hepatitis in dialysis patient appear to be necessary.

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