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巴西南部血液透析中心丙型肝炎病毒 2b 基因型与医院内传播之间关联的证据。

Evidence of association between hepatitis C virus genotype 2b and nosocomial transmissions in hemodialysis centers from southern Brazil.

机构信息

Faculdade de Medicina, Universidade Federal do Rio Grande, Rio Grande, Brazil.

出版信息

Virol J. 2013 May 29;10:167. doi: 10.1186/1743-422X-10-167.

Abstract

BACKGROUND

Hepatitis C virus infection is a serious public health problem. Hemodialysis is considered one of the main risk factors of HCV infection, due to several invasive medical procedures and potential nosocomial transmission that patients with chronic renal failure (CRF) are continuously submitted. The aims of this study were to determine the prevalence of HCV and its genotypes in patients with CRF in hemodialysis units in southern Brazil.

METHODS

Demographic data and risk factors for HCV transmission were collected and analyzed. These data were obtained from patients undergoing hemodialysis treatment from January 2009 to August 2010, on two dialysis units of Rio Grande, southern Brazil. Genotyping was carried out by sequencing analysis of HCV NS5b, core-E1 junction and 5'UTR genomic regions.

RESULTS

One hundred fifty-nine patients under regular hemodialysis treatment were studied. HCV prevalence was 23.3%. HCV-infected patients had been on dialysis treatment for 91.9 months, a more prolonged period compared to HCV-negative patients (p = 0.001). While HCV genotypes 1b and 3a were identified as the most frequent strains, a surprisingly high proportion of genotype 2b was observed among patients in one of the dialysis centers compared to the general HCV-infected population of the same area. Hemodialysis treatment exposure time and healthcare working were associated with HCV infection.

CONCLUSIONS

Besides the efforts to minimize nosocomial transmission of HCV, some events of transmission are still evidenced in dialysis units.

摘要

背景

丙型肝炎病毒感染是一个严重的公共卫生问题。血液透析被认为是丙型肝炎病毒感染的主要危险因素之一,因为慢性肾衰竭(CRF)患者需要接受多次有创的医疗程序,并且存在潜在的医院内传播。本研究的目的是确定巴西南部血液透析单位中 CRF 患者丙型肝炎病毒的流行率及其基因型。

方法

收集并分析了丙型肝炎病毒传播的人口统计学数据和危险因素。这些数据来自于 2009 年 1 月至 2010 年 8 月期间在巴西南部里奥格兰德的两个透析单位接受血液透析治疗的患者。通过 HCV NS5b、核心-E1 连接处和 5'UTR 基因组区域的测序分析进行基因分型。

结果

研究了 159 名定期接受血液透析治疗的患者。丙型肝炎病毒的流行率为 23.3%。感染丙型肝炎病毒的患者接受透析治疗的时间为 91.9 个月,比丙型肝炎病毒阴性患者的时间更长(p=0.001)。虽然 1b 和 3a 基因型被确定为最常见的菌株,但在其中一个透析中心的患者中,2b 基因型的比例出乎意料地高,与同一地区的一般丙型肝炎病毒感染人群相比。血液透析治疗暴露时间和医疗保健工作与丙型肝炎病毒感染有关。

结论

除了努力最小化丙型肝炎病毒的医院内传播外,透析单位仍有一些传播事件发生。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8234/3680315/2a9aa2391196/1743-422X-10-167-1.jpg

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