2 Members of this cohort will progressively come into more contact with the healthcare system as a

natural consequence of aging as well as to receive specific HCV-associated click here care.28 Thus, there is a growing reservoir of infected individuals who can serve as a source of transmission to others if safe injection practices and other basic infection control precautions are not followed. The potential for bloodborne pathogen transmission should be recognized whenever an invasive healthcare procedure is performed. During administration of injections and infusions, syringes and related equipment routinely become contaminated with microscopic quantities of blood.12 If syringes are reused to administer medication to more than one patient or to access shared medication,

transmission of bloodborne pathogens can occur. This has been demonstrated repeatedly in recent outbreaks caused by syringe reuse and other unsafe injection practices,10, 12, 19-22 as well as in decades-old experimental studies.12 There is also growing recognition of provider-to-patient HCV transmission in the context of narcotics theft.29 Though rarely recognized, outbreaks involving infected healthcare providers Navitoclax who obtained injectable drugs illicitly have affected large numbers of patients.29 Safe injection practices include one-time use of syringes, needles, and single-dose vials.12, 30-32 True multidose vials should be dedicated for single patient use whenever possible; when shared use is unavoidable, these should be medchemexpress handled in an aseptic manner away from potentially contaminated patient treatment areas.12, 30-32 These recommendations are part of accepted evidence-based guidelines for preventing healthcare-associated infections, but ongoing outbreaks and gaps in adherence27, 31 indicate that these need to be reinforced as part of medical and nursing school curricula, other preservice healthcare training, and mandated, routine continuing education activities.5, 12, 22, 33-35 Likewise, efforts toward enforcement of basic

standards of infection control and effective oversight activities (e.g., audits and inspections), though increasing, require strengthening at both the state and federal levels.5, 12, 21, 27 In addition, there is a critical need for broader application of safety-engineered technologies, systems, and strategies (e.g., commercial prefilled syringes utilizing tamper-proof packaging) to prevent reuse of injection equipment and limit sharing of parenteral medications.5, 35, 36 Hemodialysis, another important risk identified in our study, involves repeated, prolonged access to patient’s bloodstreams and poses long-recognized risks for bloodborne pathogen transmission.12, 37, 38 Specific infection control and hepatitis B vaccination recommendations that apply to patients undergoing care in hemodialysis settings have reduced these risks, but are often overlooked, as evidenced from ongoing outbreaks and the findings presented here.