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HIV transmission documented within hemodialysis unit in Saudi Arabia
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Data from gene sequencing suggest that three patients receiving hemodialysis in Saudi Arabia were infected with HIV by patient-to-patient contact or common source transmission, according to investigators with the Saudi Arabia Ministry of Health.
“Our investigation of the available evidence implicates non-compliant [infection prevention and control] practices as a cause of the outbreak,” they wrote in Clinical Infectious Diseases. “We were able to demonstrate a biologically plausible association between breaks in [infection prevention and control] practices and the transmission of HIV infections in [hemodialysis unit] #1.”
The investigation was launched when patient No. 1 had a positive HIV test. The patient was a 46-year-old women with end-stage renal disease and no self-reported HIV risk factors. Two additional patients among the 35 patients receiving dialysis at hemodialysis unit No. 1 subsequently tested positive for HIV and also reported no HIV risk factors: a 70-year-old woman who was seropositive for hepatitis C virus and a 30-year-old woman.
Patient No. 1 confirmed having her initial dialysis at the facility in a room reserved for patients with HCV. She shared the same dialysis nurse as patient No. 2 and received dialysis during the same nurse shift. The same machine was later used on patient No. 3. In an analysis of infection prevention and control methods, investigators found that the machine only underwent a 15-minute disinfection cycle rather than the required 45 minutes.
In addition, the nurse used blood-spattered gloves to handle the vascular access lines for multiple patients and used a shared syringe to access a multi-dose vial of heparin. The investigators evaluated other hemodialysis facilities in the region and found many variances in infection prevention and control practices, despite explicit infection control training and guidelines.
Disclosure: The researchers report no relevant financial disclosures.
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