GMS Hygiene and Infection Control最新文献

{"title":"Virucidal efficacy of a UV-C disinfection system for semi-critical medical devices according to EN 14476.","authors":"Stefan Alexander Rudhart, Klaus Wolfgang Georg Eichhorn, Marvin Rausch, Alexander Maas, Maximilian Knof, Steffen Engelhart, Nico T Mutters, Stephan Hoch, Sebastian Strieth","doi":"10.3205/dgkh000622","DOIUrl":"10.3205/dgkh000622","url":null,"abstract":"<p><strong>Purpose: </strong>Semi-critical medical devices, such as flexible endoscopes in otorhinolaryngology (ORL), require high-level disinfection due to their contact with mucous membranes. UV-C systems offer a rapid, non-toxic alternative to traditional reprocessing. This study evaluates the virucidal efficacy of the D60 UV-C disinfection system according to EN 14476 standards.</p><p><strong>Materials and methods: </strong>Standardized tests were performed using frosted glass and thermoplastic elastomer (TPE) carriers inoculated with four indicator viruses: murine norovirus (MNV), poliovirus type 1, adenovirus type 5, and simian virus 777 (SV40). After drying, carriers underwent a 60 second UV-C cycle in the D60 system. Viral recovery and titration followed EN 14476 protocols, with infectivity measured by TCID₅₀ assay.</p><p><strong>Results: </strong>All viruses showed significant reductions following UV-C treatment. Residual titers fell below the detection limit (3.2 lg TCID₅₀/mL), corresponding to >4.0 lg reduction across all tested surfaces and virus types. Adenovirus showed the highest reduction (>4.5 lg).</p><p><strong>Conclusion: </strong>The D60 system achieved broad-spectrum virucidal efficacy within one minute, meeting EN 14476 requirements. These findings support its use for safe, rapid reprocessing of semi-critical devices in high-turnover clinical settings, with potential to improve infection control and workflow efficiency.</p>","PeriodicalId":12738,"journal":{"name":"GMS Hygiene and Infection Control","volume":"21 ","pages":"Doc13"},"PeriodicalIF":1.1,"publicationDate":"2026-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12973383/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147432335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety, cost and environmental impact of reprocessing low and moderate risk single-use medical devices: a systematic review.","authors":"Niamh McGrath, Catherine Waldron, Ailish Farragher, Áine Teahan, Leila Keshtkar, Julie Polisena, Francesco Tessarolo","doi":"10.3205/dgkh000617","DOIUrl":"10.3205/dgkh000617","url":null,"abstract":"<p><strong>Objectives: </strong>Estimate the safety, financial and environmental impacts of reprocessing low and moderate risk single-use medical devices (SuMDs).</p><p><strong>Methods: </strong>Systematic review (PROSPERO ID: CRD42022365642) of primary studies of patients receiving reprocessed low and moderate risk SuMDs (non-critical and semi-critical medical devices a and b) versus first use of otherwise identical SuMDs. Items were sourced via database and supplemental searching. Results were reported by device risk class, included studies were quality appraised, and primary outcomes: direct patient safety; direct and indirect financial costs; environmental impacts, were Grade of Recommendation, Assessment, Development and Evaluation (GRADE) assessed following narrative synthesis.</p><p><strong>Results: </strong>Ten studies examined 10 devices across three categories of risk class I devices: external fixator devices (n=3 studies), compression sleeves (n=2), and pulse oximeters (n=1) and three categories of risk class II devices: ophthalmic devices (n=1), surgical instruments for grasping and cutting (n=1) and endoscopic and laparoscopic devices (n=5 studies, 5 devices). There were no significant differences in the odds of primary safety outcomes across the two device types contributing data. The only study contributing primary financial impact data reported no statistically significant difference in savings for new versus reprocessed devices (p=0.340). Reprocessing reduced global warming (n=2 studies) and increased human health impacts (n=1) across the four device types contributing data. The certainty of safety and cost evidence was very low.</p><p><strong>Conclusions: </strong>Safety monitoring systems where SuMD reprocessing is permitted are required. Reprocessing costs should be estimated using appropriate methodologies and research is needed to ensure that life cycle assessment study designs can be better utilised to inform decision-making.</p>","PeriodicalId":12738,"journal":{"name":"GMS Hygiene and Infection Control","volume":"21 ","pages":"Doc08"},"PeriodicalIF":1.1,"publicationDate":"2026-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12921675/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147270859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Needle-free connectors in tunneled central venous catheters for hemodialysis: A prospective single-centre safety and feasibility study.","authors":"Boštjan Leskovar, Tjaša Furlan","doi":"10.3205/dgkh000616","DOIUrl":"10.3205/dgkh000616","url":null,"abstract":"<p><strong>Background: </strong>Tunnelled central venous catheters (t-CVCs) remain essential for hemodialysis when arteriovenous access is not feasible, but catheter-related bloodstream infection (CRBSI) is a major risk. In temporary CVCs, needle-free connectors have been associated with fewer infections; however, data on high-flow hemodialysis catheters are limited. We evaluated the short-term safety and feasibility of high-flow split-septum needle-free connectors on hemodialysis temporary central venous catheters (t-CVCs).</p><p><strong>Methods: </strong>In a prospective single-centre study (Trbovlje General Hospital, Slovenia; June 2025), adults with a mature t-CVC used for thrice-weekly hemodialysis and without signs of infection were enrolled. Split-septum needle-free connectors (Asset-FlowArt^®-1010H-S) with antibacterial caps were applied to both hubs and used for 12 consecutive dialysis sessions per patient. The primary outcome was microbiological safety, defined as negativity of paired blood cultures after 12 sessions. Secondary outcomes included clinical tunnel infection, change in inflammatory markers, need to modify dialysis prescription/anticoagulation/catheter care, mechanical complications, hospitalization, and death.</p><p><strong>Results: </strong>Fifteen patients completed 12 sessions each (total 180 sessions). Paired blood cultures were negative at baseline and after 12 sessions in all patients. No tunnel infections occurred. There were no meaningful changes in inflammatory markers, and no device-related adverse events or protocol modifications were required. No hospitalizations or deaths occurred during follow-up. Flow performance supported prescribed blood-flow rates.</p><p><strong>Conclusion: </strong>In this short-term single-centre cohort, high-flow split-septum needle-free connectors appeared feasible and microbiologically safe on hemodialysis t-CVCs, without compromising dialysis delivery or routine catheter care. Larger, multicenter randomized trials with longer follow-up are warranted to determine effects on CRBSI incidence and catheter patency.</p>","PeriodicalId":12738,"journal":{"name":"GMS Hygiene and Infection Control","volume":"21 ","pages":"Doc07"},"PeriodicalIF":1.1,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12914504/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146226627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oral and maxillofacial manifestations of COVID-19.","authors":"Pooja Palwankar, Jaganbabu Palaniappan, Kavitha Kuttappan, Ruchi Pandey, Shalu Verma, Amit Bhardwaj, Karthik Shunmugavelu","doi":"10.3205/dgkh000614","DOIUrl":"10.3205/dgkh000614","url":null,"abstract":"<p><p>An overview of oral and maxillofacial manifestations associated with COVID-19 is provided. The symptoms range from white, red and mixed inflamed mucosal areas, necrosis, swelling, ulcers, vesicle, bulla, pustule, pigmentation, depapillated and fissured tongue and bleeding in the ulcers. Pre-COVID symptoms included complete loss of taste, along with reduced sense of taste and alterations in the taste perception.</p>","PeriodicalId":12738,"journal":{"name":"GMS Hygiene and Infection Control","volume":"21 ","pages":"Doc05"},"PeriodicalIF":1.1,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12914503/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146226682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How to get cheap clean air? Implementation of an affordable high-efficient air filtration ventilation system for operating theatres in a low-resource setting.","authors":"Christian Leonhard Doll, Rolf Opalka, Leonel Tchamo Nguifo, Alaric Tamuedjoun Talom, Lazare Kuate Kamdem, Alexandra Will, Lilith Johannsen, Florian Geiger, Andrej Trampuz","doi":"10.3205/dgkh000615","DOIUrl":"10.3205/dgkh000615","url":null,"abstract":"<p><strong>Aim: </strong>Clean air in the operating theatre (OT) is crucial for safe surgery in order to prevent surgical site infections. Air filtration devices are standard in most OT as required by international guidelines and regulations. However, in low-resource settings, common air filtration devices are only scarcely found in OT, mainly due to high cost. Context-adapted low-cost solutions for clean air in OT are urgently needed but not available. The aim of this study was to assess the effectiveness of a new mechanical air filtration system for OTs, to describe its technical details and compare its performance with DIN/ISO standards and natural window ventilation, at a district hospital in Mbouo, Cameroon.</p><p><strong>Methods: </strong>An affordable (3,500 €) high-efficient air filtration system was developed, locally constructed and implemented. An evaluation was done after 4 years of regular use, comparing the system with ISO/DIN guidelines.</p><p><strong>Results: </strong>The device was still working properly after 4 years of regular use without any maintenance. The air filtration system reduced particles in the OT by >97%. The microbial contamination in the OT air was reduced by 72% after starting the device. Although it is not fully compliant with all DIN/ISO requirements, the ventilation system greatly improved the cleanliness of the OT air compared to 'natural' window-based ventilation.</p><p><strong>Conclusions: </strong>This pilot study showed the feasibility and quality of a new context-adapted affordable air filtration device for OT in low-resource settings. Further studies and upscaling are needed. Construction plans are freely available.</p>","PeriodicalId":12738,"journal":{"name":"GMS Hygiene and Infection Control","volume":"21 ","pages":"Doc06"},"PeriodicalIF":1.1,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12914505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146226688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aeromonas caviae: A rare case of hepatic abscess.","authors":"Aristos Aristodimou, Zacharias Raptopoulos, Andreas Kostis, Elena Xenofontos, Loukia Dramiotou","doi":"10.3205/dgkh000612","DOIUrl":"10.3205/dgkh000612","url":null,"abstract":"<p><strong>Aim: </strong>The aim of this report is to present, to our knowledge, the first case of <i>Aeromonas (A.) caviae</i> liver abscess.</p><p><strong>Methods: </strong>The following manuscript describes a case of a 75-year-old female patient with past medical history of pancreatic cancer, lung cancer, hypothyroidism, hypertension and chronic venous insufficiency who was diagnosed with <i>A. caviae</i> bacteremia and multiple liver abscesses in the right lobe. The patient was treated conservatively, with intravenous antibiotics for two months with adequate recovery.</p><p><strong>Discussion: </strong><i>Aeromonas</i> spp. is a Gram-negative, facultative anaerobic microorganism that lives in aquatic environments. There are many subtypes of <i>Aeromonas</i> spp., with the commonest being <i>A. hydrophila</i>, <i>A. sobria</i> and <i>A. caviae</i>. They tend to cause gastrointestinal and hepatobiliary disease in immunocompromised people, mostly those with underlined disease or malignancy of the hepatobiliary tract.</p><p><strong>Conclusion: </strong><i>Aeromonas</i> spp. has been identified in chlorinated tap water, worldwide. Global warming contributes not only to the reproduction of more bacteria, but also to the development of antibiotic resistance genes and biofilms. Besides the fact that liver abscess due to <i>Aeromonas caviae</i> is rare; the following report highlights a major, public health concern, that is Global warming, and the devastating impact it can have on healthcare.</p>","PeriodicalId":12738,"journal":{"name":"GMS Hygiene and Infection Control","volume":"21 ","pages":"Doc03"},"PeriodicalIF":1.1,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12914374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146226639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dental patients' views on oral health and hygiene: a questionnaire-based assessment in Bangladesh.","authors":"Majedul Hoque, Md Aktaruzzaman, Md Nahid Hasan","doi":"10.3205/dgkh000613","DOIUrl":"10.3205/dgkh000613","url":null,"abstract":"<p><strong>Background: </strong>A major influence on quality of life is caused by the general public's inability to recognize poor oral health and untreated oral disorders, as well as the widespread acceptance of poor oral status as the standard. Because they are so common and often ignored, oral diseases pose an existential risk to public health. People's attitudes regarding oral health and illness, therefore, have a significant impact on dental health. This study aims to assess the patients' behavior, attitudes, and level of knowledge while visiting or seeking dental treatment at various dental care clinics in Kishoreganj, Bangladesh.</p><p><strong>Methods: </strong>A structured self-chosen questionnaire, that takes 5-10 minutes to complete, was posed to general patients visiting dental care. The individuals' responses were computed as percentages.</p><p><strong>Results: </strong>Among the 214 participants, 67% brush their teeth two times daily. About 72% patients change their toothbrush following 2 months of usage and 6% patients change it within 6 months. Among the patients 44% stated primary information source about dental health is their parents. Majority patients 84% know that oral health have influence over general well-being of our life and the practice of cleaning mouth and making gurgle after eating food is prevalent among participants by just below 50%.</p><p><strong>Conclusion: </strong>The study participants' attitudes, practice and awareness of their dental health are reasonable, but they fall short of what is needed. Consequently, it is essential to offer instruction and encouragement regarding oral health and associated challenges.</p>","PeriodicalId":12738,"journal":{"name":"GMS Hygiene and Infection Control","volume":"21 ","pages":"Doc04"},"PeriodicalIF":1.1,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12914372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146226619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comparative study of the therapeutic efficacy of various intralesional immunotherapies in extragenital cutaneous warts.","authors":"Nimisha Kabra, Rajesh Sinha, U K Pallavi","doi":"10.3205/dgkh000611","DOIUrl":"10.3205/dgkh000611","url":null,"abstract":"<p><strong>Background: </strong>Cutaneous warts are caused by human papilloma virus (HPV). Most of the current removal modalities are ablative which is associated with recurrence and scarring at the site. Immunotherapy can overcome these limitations, and also distant warts can be treated simultaneously.</p><p><strong>Aims: </strong>To compare the efficacy of three immunotherapeutic agents, measles-mumps-rubella (MMR) vaccine, Bacillus Calmette Guerin (BCG) vaccine, and vitamin D3 injection in the treatment of multiple extragenital cutaneous warts and to assess the safety and recurrence rates of different intralesional immunotherapeutic agents.</p><p><strong>Materials and methods: </strong>Sixty patients with extragenital cutaneous warts were enrolled in the study and randomized into three groups: Group A: MMR (0.5 mL of reconstituted MMR vaccine); Group B: BCG (0.1 ml BCG); and Group C: vitamin D3 (0.5 mL Inj. vitamin D3 600,000 IU; 15 mg/ml). A target wart was selected, and the intralesional injections were given at a three-week interval for a maximum of five doses. The response was observed in target and distant warts. Adverse effects were noted. Cases were followed up monthly for two months.</p><p><strong>Results: </strong>The baseline characteristics were comparable across MMR, BCG, and vitamin D3 groups. MMR showed significantly higher complete clearance at both injected (90%) and distant (80%) sites compared to BCG (60%, 40%) and vitamin D3 (25%, 20%) at the final follow-up. MMR was significantly superior to vitamin D3 (p=0.002) in injected warts and in distant warts (p=0.03) at last follow up. Intention-to-treat analysis and Kaplan-Meier survival confirmed a faster and more effective response with MMR (mean 5.3 weeks). Hazard ratios indicated a 95% and 99% lower probability of clearance with BCG and vitamin D3, respectively, compared to MMR. Pain was the most common adverse effect, being highest in vitamin D3 group (80%). There was recurrence in 3 cases in the MMR group, recurrence in 1 case and no recurrence in the vitamin D3 group upon follow-up.</p><p><strong>Conclusion: </strong>The intralesional MMR vaccine was found to be significantly more effective than BCG and vitamin D3 in treating extragenital cutaneous warts. This makes immunotherapy a promising modality for the treatment of multiple and recalcitrant extragenital cutaneous warts.</p>","PeriodicalId":12738,"journal":{"name":"GMS Hygiene and Infection Control","volume":"21 ","pages":"Doc02"},"PeriodicalIF":1.1,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12914375/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146226624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Monoclonal outbreak caused by ceftazidime-avibactam resistant bla_OXA-48-positive, carbapenem-resistant Klebsiella pneumoniae in an intensive care unit.","authors":"Bahise Çağla Taşkın Dalgıç, Elif Seren Tanriverdi, İlayda Budak, Gülgün Yenişehirli, Barış Otlu","doi":"10.3205/dgkh000610","DOIUrl":"10.3205/dgkh000610","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to determine the ceftazidime-avibactam susceptibilities and clonal relationships of <i>bla</i> <i>_OXA-48</i> -positive, carbapenem-resistant <i>K. pneumaniae</i> (CRKP) isolates.</p><p><strong>Methods: </strong>Fifteen <i>K. pneumaniae</i> isolates from various clinical samples, determined as <i>bla</i> <i>_OXA-48</i> -positive CRKP by VITEK 2 compact system and multiplex PCR, were included in the study. Colistin susceptibility of isolates was tested using the broth microdilution method. The Kirby-Bauer disk diffusion test was performed for CAZ-AVI susceptibility. Arbitrary primer sequence-based PCR (AP-PCR) was used to investigate genotypic similarity between the isolates.</p><p><strong>Results: </strong>All 15 <i>bla</i> <i>_OXA-48</i> -positive CRKP isolates were resistant to meropenem, ertapenem, imipenem, amikacin, gentamicin, ciprofloxacin and levoflokxacin. Four of the CRKP isolates were susceptible to SXT and colistin. 73.3% (11/15) of the CRKP isolates were found to be resistant to CAZ-AVI. One of the 15 <i>bla</i> <i>_OXA-48</i> -positive CRKP isolates was also a <i>bla</i> <i>_NDM</i> carrier. AP-PCR revealed that 15 isolates showed five different genotypes. Eleven of the isolates were classified under genotype 1, leading to a clustering rate of 73.3%. Isolates in the genotype 1 group were defined as outbreak isolates. All but one of the genotype 1 outbreak isolates were resistant to all antibiotics studied, including CAZ-AVI and colistin.</p><p><strong>Conclusion: </strong>This study evaluated an intensive care unit outbreak caused by a clone resistant to CAZ-AVI, which has been reported to have susceptibility rates of up to 100% in OXA-48-producing CRKP isolates and is suggested as first choice therapy. To prevent the spread of CAZ-AVI-resistant CRKP isolates, it is essential to conduct active surveillance studies in hospitals. Especially ICUs - where these strains are common - should be routinely screened. Infection control practices in general must also be tightened.</p>","PeriodicalId":12738,"journal":{"name":"GMS Hygiene and Infection Control","volume":"21 ","pages":"Doc01"},"PeriodicalIF":1.1,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12914368/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146226685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of hepatitis C transmission by healthcare workers - a systematic review.","authors":"Roland Diel, Albert Nienhaus","doi":"10.3205/dgkh000609","DOIUrl":"10.3205/dgkh000609","url":null,"abstract":"<p><strong>Background: </strong>Occupational acquisition of hepatitis C virus (HCV) among healthcare workers (HCWs) has markedly declined in high-income countries, largely due to improved infection control measures and safety-engineered devices. However, the risk of HCV transmission from HCWs to patients remains insufficiently characterized.</p><p><strong>Methods: </strong>We conducted a systematic review of studies reporting serological evidence of HCV transmission from infected HCWs to patients. Following PRISMA guidelines, we searched MEDLINE, Scopus, and Cochrane databases for publications up to July 2025.</p><p><strong>Results: </strong>Of 192 studies identified, 24 from eight countries met inclusion criteria. In total, 27 HCWs were implicated as potential sources, and 54,622 patients were tested for HCV RNA. Seventy-six transmissions were confirmed by RNA sequencing; 369 were classified as probable and 15 as possible. Direct provider-to-patient transmission was documented in 18 studies, 12 of which involved exposure-prone procedures (EPP), yielding a mean transmission rate of 0.47% (62/13,224; 95% CI 0.036-0.061%). Viral load data were reported for only eight transmitting HCWs, all with ≥2×10⁵ IU/mL, while no measurements were available for the remaining 19. Given the rarity of direct transmission and the absence of validated HCV RNA thresholds, national guidelines (UK, Germany, the Netherlands, Belgium, France, Switzerland, USA) differ considerably regarding restrictions or monitoring of infected HCWs performing EPP. Indirect HCV transmission associated with diversion of opiates and injection-safety breaches by HCWs addicted to morphine accounted for an even higher risk, with a mean rate of 0.94% (389/41,398; 95% CI 0.85-1.04%).</p><p><strong>Conclusions: </strong>Evidence on HCW-to-patient HCV transmission remains limited and provides only weak guidance for national prevention policies. Indirect transmission through unsafe practices by opioid diversion has emerged as the predominant pathway, underscoring the need for real-time monitoring, tamper-resistant systems, and strict adherence to infection prevention measures in healthcare settings.</p>","PeriodicalId":12738,"journal":{"name":"GMS Hygiene and Infection Control","volume":"20 ","pages":"Doc80"},"PeriodicalIF":1.6,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12720405/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145819030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}