Use of the minimum spanning tree model for molecular epidemiological investigation of a nosocomial outbreak of hepatitis C virus infection

dc.contributor.author	Spada, E	en
dc.contributor.author	Sagliocca, L	en
dc.contributor.author	Sourdis, J	en
dc.contributor.author	Garbuglia, AR	en
dc.contributor.author	Poggi, V	en
dc.contributor.author	De Fusco, C	en
dc.contributor.author	Mele, A	en
dc.date.accessioned	2014-06-06T06:46:11Z
dc.date.available	2014-06-06T06:46:11Z
dc.date.issued	2004	en
dc.identifier.issn	00951137	en
dc.identifier.uri	http://dx.doi.org/10.1128/JCM.42.9.4230-4236.2004	en
dc.identifier.uri	http://62.217.125.90/xmlui/handle/123456789/2834
dc.subject.other	hepatitis C antibody	en
dc.subject.other	virus RNA	en
dc.subject.other	article	en
dc.subject.other	blood analysis	en
dc.subject.other	blood smear	en
dc.subject.other	central venous catheter	en
dc.subject.other	child	en
dc.subject.other	controlled study	en
dc.subject.other	E3 gene	en
dc.subject.other	epidemic	en
dc.subject.other	epidemiological data	en
dc.subject.other	gene sequence	en
dc.subject.other	genotype	en
dc.subject.other	health care personnel	en
dc.subject.other	hepatitis C	en
dc.subject.other	Hepatitis C virus	en
dc.subject.other	hospital infection	en
dc.subject.other	human	en
dc.subject.other	major clinical study	en
dc.subject.other	minimum spanning tree model	en
dc.subject.other	model	en
dc.subject.other	nucleotide sequence	en
dc.subject.other	outpatient department	en
dc.subject.other	phylogenetic tree	en
dc.subject.other	priority journal	en
dc.subject.other	sequence analysis	en
dc.subject.other	seroconversion	en
dc.subject.other	virus detection	en
dc.subject.other	virus gene	en
dc.subject.other	virus transmission	en
dc.subject.other	Child	en
dc.subject.other	Cross Infection	en
dc.subject.other	Disease Outbreaks	en
dc.subject.other	Epidemiology, Molecular	en
dc.subject.other	Female	en
dc.subject.other	Hepacivirus	en
dc.subject.other	Hepatitis C	en
dc.subject.other	Humans	en
dc.subject.other	Inpatients	en
dc.subject.other	Italy	en
dc.subject.other	Male	en
dc.subject.other	Models, Theoretical	en
dc.subject.other	Outpatients	en
dc.subject.other	Phylogeny	en
dc.subject.other	RNA, Viral	en
dc.subject.other	Hepatitis C virus	en
dc.subject.other	RNA viruses	en
dc.title	Use of the minimum spanning tree model for molecular epidemiological investigation of a nosocomial outbreak of hepatitis C virus infection	en
heal.type	journalArticle	en
heal.identifier.primary	10.1128/JCM.42.9.4230-4236.2004	en
heal.publicationDate	2004	en
heal.abstract	The minimum spanning tree (MST) model was applied to identify the history of transmission of hepatitis C virus (HCV) infection in an outbreak involving five children attending a pediatric oncology-hematology outpatient ward between 1992 and 2000. We collected blood samples from all children attending since 1992, all household contacts, and one health care worker positive for antibody to HCV (anti-HCV). HCV RNA detection was performed with these samples and with smears of routinely collected bone marrow samples. For all isolates, we performed sequence analysis and phylogenetic tree analysis of hypervariable region 1 of the E2 gene. The MST model was applied to clinical-epidemiological and molecular data. No additional cases were detected. All children, bat not the health care worker, showed genotype 3a. On six occasions, all but one child had shared the medication room with another patient who later seroconverted. HCV RNA detection in bone marrow smears revealed, in some cases, a delay of several months in anti-HCV responses. Sequence analysis and phylogenetic tree analysis revealed a high identity among the isolates. The MST model applied to molecular data, together with the clinical-epidemiological data, allowed us to identify the source of the outbreak and the most probable patient-to-patient chain of transmission. The management of central venous catheters was suspected to be the probable route of transmission. In conclusion, the MST model, supported by an exhaustive clinkal-epidemiological investigation, appears to be a useful tool in tracing the history of transmission in outbreaks of HCV infection.	en
heal.journalName	Journal of Clinical Microbiology	en
dc.identifier.issue	9	en
dc.identifier.volume	42	en
dc.identifier.doi	10.1128/JCM.42.9.4230-4236.2004	en
dc.identifier.spage	4230	en
dc.identifier.epage	4236	en