A systematic review of outbreaks of bloodborne infections (hepatitis B and C, HIV) transmitted from patient to patient in healthcare settings

Abstract

Healthcare facilities have always played an important role in transmission of bloodborne infections. Procedures involving blood and blood fluids pose a risk of transmitting hepatitis B, hepatitis C and HIV not only to healthcare workers, but also to patients. To assess the role of healthcare facilities in transmission of bloodborne infections and to identify risk groups among patients as well as transmission factors, a total of 75 outbreaks of hepatitis B, hepatitis C and HIV have been analyzed with reference to the data published in different countries in 2008–2020. The comparative analysis was conducted for the outbreaks in the United States during 1992–2008 and 2008–2019. Most of the outbreaks of bloodborne infections at healthcare facilities were caused by non-adherence to standard precautions among healthcare workers: Reusing disposable items; improper handwashing; reusing gloves; non-disinfecting surfaces, reusable equipment and devices; non-sterilizing reusable instruments. In terms of bloodborne infections, high-risk facilities include hemodialysis centers, oncohematology clinics, outpatient clinics, nursing homes, residential care facilities, and diabetes treatment centers. High-risk groups include patients undergoing hemodialysis, oncohematological patients, and patients with diabetes. Diagnosis of bloodborne infections on a regular basis, hepatitis B vaccination among high-risk patients, investigation of outbreaks, adoption of rules and procedures combined with training and compliance control of healthcare workers contribute to solution of the problem associated with nosocomial transmission of bloodborne infections.

Keywords

• review
• nosocomial outbreak
• healthcare-associated outbreak
• bloodborne infections
• hepatitis b
• hepatitis c
• hiv