Abstract
The present condition of the hospital infection and infection control in hemodialysis (HD) therapy was investigated.
We mailed questionnaire to 2910 hemodialysis facilities in Japan and recovered them from 1681 facilities (57.8%). The recoveries from private facilities were lower (44.8%) than those from other facilities (51.7%). There were no differences by region or facility scale. 81.6% of facilities had made their infection control manual, and the infection control committees were founded at the 74.5% of facilities. The 2/3 of facilities opened infection control committee every month. HBs antigen and HCV antibody were measured in 93.3% and 98.4%, and were positive in 2.84% and 22.4% of patients, respectively. HBs antigen and HCV antibody positive rate were different between 7 regions (p=0.00515, p<0.0001) and between founders (p<0.0001, p<0.0001). HBs antigen and HCV antibody positive rate of facilities showed positive correlation with dialysis period (p=0.00308, p<0.0001). There was a weak correlation between HBs antigen positive rate and HCV antibody positive rate of facilities (r=.145, p<0.0001). Meantime, HB vaccination was carried out only in 24.3% of facilities, room isolation of HBs antigen positive patient in 1.88%, and bed fixation in 59.0% facilities. In the HCV antibody positive patients, room isolation was done in 0.674%, and bed fixation in 43.2%. Some facilities reported reuse of syringes for drug administration (2.06%), reuse of leftover isotonic sodium chloride solution, and divided dosage (5.54%) of erythropoietin ample. The daily attention for HBs antigen positive patients, bed fixation, notification, and daily life consultation for the HCV antibody positive patient were considered to be mandatory.
We conclude that hemodialysis patients were suffered from viral hepatitis, and the infection control measures were mandatory. Prospective study on the risk of the hospital infection control and investigation on the precaution will be further necessary.
