Mason B W, Cartwright J, Sandham S, Whiteside C, Salmon R L
Communicable Disease Surveillance Centre Wales, National Public Health Service for Wales, The Temple of Peace and Health, Cathays Park, Cardiff CF103NW.
Br Dent J. 2008 Aug 23;205(4):E8; discussion 194-5. doi: 10.1038/sj.bdj.2008.656. Epub 2008 Jul 25.
To investigate the association between treatment by a dental healthcare worker (HCW) and patient infection with a blood-borne virus (BBV).
Nested case control study.
A patient notification exercise (PNE) arising from a hepatitis C virus positive HCW that was undertaken because of deficiencies in infection control practice.
Cases were individuals with a BBV infection identified as a result of the PNE. Controls were randomly selected individuals with negative tests for BBVs. Detailed information on dental treatment was obtained from patient notes. Information on risk factors for BBV infection was obtained using a structured questionnaire administered by telephone interview.
Thirty patients had evidence of infection with a BBV. The mean number of visits for treatment was 20.5 in cases and 18.6 in controls; the difference 1.8 (95% CI -5.4 to 9.1) was not statistically significant (p = 0.62). Transmission of hepatitis C in the dental setting was excluded by sequencing of the viral genome or establishing alternative risk factors.
There was no evidence of transmission of hepatitis C virus from the HCW to patients, or transmission of a BBV from patient to patient. To ensure consistent practice within the UK the National Institute for Health and Clinical Excellence should produce guidance on PNEs for the NHS.
调查牙科医护人员(HCW)的治疗与患者感染血源病毒(BBV)之间的关联。
巢式病例对照研究。
因感染控制措施存在缺陷,对一名丙型肝炎病毒呈阳性的医护人员开展了患者通报行动(PNE)。
病例为因PNE而被确定感染BBV的个体。对照为随机选取的BBV检测呈阴性的个体。从患者病历中获取有关牙科治疗的详细信息。使用通过电话访谈进行管理的结构化问卷获取有关BBV感染危险因素的信息。
30名患者有感染BBV的证据。病例组的平均治疗就诊次数为20.5次,对照组为18.6次;差异1.8(95%CI -5.4至9.1)无统计学意义(p = 0.62)。通过病毒基因组测序或确定其他危险因素排除了牙科环境中丙型肝炎的传播。
没有证据表明丙型肝炎病毒从医护人员传播给患者,或BBV在患者之间传播。为确保英国国内做法的一致性,英国国家卫生与临床优化研究所应为国民保健制度制定关于患者通报行动的指南。