{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2022,4,2]],"date-time":"2022-04-02T16:36:57Z","timestamp":1648917417621},"reference-count":32,"publisher":"Cambridge University Press (CUP)","issue":"10","license":[{"start":{"date-parts":[[2015,7,22]],"date-time":"2015-07-22T00:00:00Z","timestamp":1437523200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2015,10]]},"abstract":"<jats:sec id=\"S0899823X15001658_abs1\" sec-type=\"general\"><jats:title>OBJECTIVE<\/jats:title><jats:p>To determine whether reuse of insulin pens among multiple patients resulted in transmission of bloodborne pathogens (BBP).<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X15001658_abs2\" sec-type=\"general\"><jats:title>DESIGN<\/jats:title><jats:p>Retrospective cohort study.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X15001658_abs3\" sec-type=\"general\"><jats:title>SETTING<\/jats:title><jats:p>Two Veterans Affairs medical centers.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X15001658_abs4\" sec-type=\"general\"><jats:title>PATIENTS<\/jats:title><jats:p>Veterans who received insulin via insulin pens from 2010 to 2013.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X15001658_abs5\" sec-type=\"methods\"><jats:title>METHODS<\/jats:title><jats:p>Patients were identified through electronic health records, notified of possible exposure, and serotested for human immunodeficiency virus, hepatitis C virus (HCV), and hepatitis B virus. Newly discovered case patients were assessed in relation to potential proximate patients to determine viral strain relatedness by HCV envelope (<jats:italic>env<\/jats:italic>) gene sequencing.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X15001658_abs6\" sec-type=\"results\"><jats:title>RESULTS<\/jats:title><jats:p>Of 1,791 hospitalized veterans who received insulin via insulin pen, 1,155 were tested for at least 1 viral infection after exposure. Of these, 67 patients were newly diagnosed with 1 or more viral BBPs. For human immunodeficiency virus and hepatitis B virus no additional strain testing of case or proximate patients was possible; 8 HCV cases and 45 proximates (40 unique patients; 5 patients were positive for 2 genotypes) were identified as needing strain testing. Only 3 cases and their 19 proximates had samples available for further testing. None of the 26 remaining proximate patients had blood available for further testing. Median genetic distance between the HCV <jats:italic>env<\/jats:italic> sequences of those available for additional testing ranged from 14% to 24%, indicating nonrelatedness.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X15001658_abs7\" sec-type=\"conclusions\"><jats:title>CONCLUSIONS<\/jats:title><jats:p>Our investigation revealed that exposure to insulin pen reuse did not result in HCV transmission among patients who had viral genetic analysis performed. Analysis for any additional potential transmission of blood-borne pathogens was limited by the available samples.<\/jats:p><jats:p><jats:italic>Infect Control Hosp Epidemiol<\/jats:italic> 2015;36(10):1121\u20131129<\/jats:p><\/jats:sec>","DOI":"10.1017\/ice.2015.165","type":"journal-article","created":{"date-parts":[[2015,7,22]],"date-time":"2015-07-22T01:03:09Z","timestamp":1437526989000},"page":"1121-1129","source":"Crossref","is-referenced-by-count":0,"title":["Reuse of Insulin Pens Among Multiple Patients at 2 Veterans Affairs Medical Centers"],"prefix":"10.1017","volume":"36","author":[{"given":"Patricia","family":"Schirmer","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carla A.","family":"Winston","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cynthia","family":"Lucero-Obusan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Winters","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alan","family":"Lesse","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles","family":"de Comarmond","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gina","family":"Oda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard A.","family":"Martinello","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Holodniy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2015,7,22]]},"reference":[{"key":"S0899823X15001658_ref21","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-3062.2009.00406.x"},{"key":"S0899823X15001658_ref19","doi-asserted-by":"publisher","DOI":"10.1001\/jama.296.16.2005"},{"key":"S0899823X15001658_ref6","unstructured":"Cross contamination with insulin pens. ISMP Medication Safety Alert website. http:\/\/www.ismp.org\/newsletters\/acutecare\/articles\/20080327_1.asp. Published 2008. Accessed May 22, 2014."},{"key":"S0899823X15001658_ref16","doi-asserted-by":"publisher","DOI":"10.1089\/omi.1.2000.5.129"},{"key":"S0899823X15001658_ref12","unstructured":"Healthcare inspection\u2014review of veterans health administration follow-up on inappropriate use of insulin pens at medical facilities. Report No 13-01987-263. Department of Veteran Affairs Office of Inspector General website. http:\/\/www.va.gov\/oig\/pubs\/VAOIG-13-01987-263.pdf. Published 2013. Accessed March 24, 2015."},{"key":"S0899823X15001658_ref18","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2006.06.007"},{"key":"S0899823X15001658_ref32","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2014.302090"},{"key":"S0899823X15001658_ref30","unstructured":"Viral hepatitis. Department of Veterans Affairs website. http:\/\/www.hepatitis.va.gov\/provider\/index.asp. Published 2015. Accessed July 8, 2015."},{"key":"S0899823X15001658_ref29","unstructured":"US Preventive Services Task Force. Infectious diseases recommendations for hepatitis B virus, hepatitis C virus and human immunodeficiency virus. US Preventive Services Task Force website. http:\/\/www.uspreventiveservicestaskforce.org\/BrowseRec\/Index. Published 2013-2014. Accessed June 12, 2015."},{"key":"S0899823X15001658_ref11","unstructured":"AL No. 13-04-Multi-dose pen injectors. VA Patient Safety Alert website. http:\/\/www.patientsafety.va.gov\/docs\/alerts\/AL13-04MultiDosePens.pdf. Published 2013. Accessed May 22, 2014."},{"key":"S0899823X15001658_ref23","unstructured":"Nassau University Medical Center press release. Nassau University Medical Center website. http:\/\/www.nuhealth.net\/pressreleasedetail.asp?ID=340. Published 2008. Accessed May 22, 2014."},{"key":"S0899823X15001658_ref7","unstructured":"Considering Insulin pens for routine hospital use? ISMP Medication Safety Alert website. http:\/\/www.ismp.org\/newsletters\/acutecare\/articles\/20080508.asp. Published 2008. Accessed May 22, 2014."},{"key":"S0899823X15001658_ref2","unstructured":"Insulin pens and pen needles. BD Diabetes Learning Center website. http:\/\/www.bd.com\/us\/diabetes\/page.aspx?cat=7001&id=7254. Accessed May 22, 2014."},{"key":"S0899823X15001658_ref24","unstructured":"Dean Clinic says patients may have been exposed to hepatitis, HIV. Wisconsin State Journal website. http:\/\/host.madison.com\/news\/local\/health_med_fit\/dean-clinic-says-patients-may-have-been-exposed-to-hepatitis\/article_5806e8b6-d261-11e0-8dcb-001cc4c002e0.html. Published 2011. Accessed July 6, 2015."},{"key":"S0899823X15001658_ref14","doi-asserted-by":"publisher","DOI":"10.1177\/003335490912400320"},{"key":"S0899823X15001658_ref9","unstructured":"Information for healthcare professionals: risk of transmission of blood-borne pathogens from shared use of insulin pens. US Food and Drug Administration website. http:\/\/www.fda.gov\/Drugs\/DrugSafety\/PostmarketDrugSafetyInformationforPatientsandProviders\/DrugSafetyInformationforHeathcareProfessionals\/ucm133352.htm. Published 2009. Accessed May 22, 2014."},{"key":"S0899823X15001658_ref1","unstructured":"Healthcare inspection-inappropriate use of insulin pens VA Western New York Healthcare System Buffalo, New York. Report No. 13-01320-200. Department of Veteran Affairs Office of Inspector General website. http:\/\/www.va.gov\/oig\/pubs\/VAOIG-13-01320-200.pdf. Published 2013. Accessed May 22, 2014."},{"key":"S0899823X15001658_ref10","unstructured":"Insulin pens must never be used for more than one person. Centers for Disease Control and Prevention Clinical Reminder website. http:\/\/www.cdc.gov\/injectionsafety\/clinical-reminders\/insulin-pens.html. Published 2012. Accessed May 22, 2014."},{"key":"S0899823X15001658_ref20","doi-asserted-by":"publisher","DOI":"10.1016\/j.jviromet.2008.05.005"},{"key":"S0899823X15001658_ref27","unstructured":"Ochs R . Nassau Medical Center extends warning over insulin pen. Newsday website. http:\/\/www.diabeticconnect.com\/diabetes-news\/general\/324-nassau-medical-center-extends-warning-over-insulin-pen. Published 2008. Accessed May 22, 2014."},{"key":"S0899823X15001658_ref15","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-1007262"},{"key":"S0899823X15001658_ref8","unstructured":"Reuse of insulin pen for multiple patients risks transmission of bloodborne disease. ISMP Medication Safety Alert website. http:\/\/www.ismp.org\/newsletters\/acutecare\/articles\/20090212-2.asp. Published 2009. Accessed May 22, 2014."},{"key":"S0899823X15001658_ref3","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.21.9.1502"},{"key":"S0899823X15001658_ref28","unstructured":"Griffin Hospital news release. Griffin Hospital alerts patients to possible insulin pen misuse. Griffin Hospital website. http:\/\/www.griffinhealth.org\/About-Us\/News-Releases\/Post\/8018\/Insulin-Pen-Notification. Published 2014. Accessed June 19, 2014."},{"key":"S0899823X15001658_ref31","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2013.301376"},{"key":"S0899823X15001658_ref25","unstructured":"Olean General Hospital press release. Olean General Hospital website. http:\/\/www.ogh.org\/programs-and-services\/diabetes\/Press%20Release-OGH%20Alerts%20Patients%20to%20Possible%20Insulin%20Pen%20Re-use.pdf. Published 2013. Accessed May 22, 2014."},{"key":"S0899823X15001658_ref22","doi-asserted-by":"publisher","DOI":"10.7205\/MILMED-D-11-00458"},{"key":"S0899823X15001658_ref4","doi-asserted-by":"publisher","DOI":"10.2146\/ajhp120728"},{"key":"S0899823X15001658_ref5","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.24.3.603"},{"key":"S0899823X15001658_ref26","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2009.497"},{"key":"S0899823X15001658_ref13","unstructured":"VHA Directive 1058. Office of Research and Oversight website. http:\/\/www1.va.gov\/vhapublications\/ViewPublication.asp?pub_ID=1825. Published 2009. Accessed September 25, 2014."},{"key":"S0899823X15001658_ref17","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.162.3.345"}],"container-title":["Infection Control &amp; Hospital Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0899823X15001658","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,4,20]],"date-time":"2019-04-20T15:10:18Z","timestamp":1555773018000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0899823X15001658\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,7,22]]},"references-count":32,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2015,10]]}},"alternative-id":["S0899823X15001658"],"URL":"https:\/\/doi.org\/10.1017\/ice.2015.165","relation":{},"ISSN":["0899-823X","1559-6834"],"issn-type":[{"value":"0899-823X","type":"print"},{"value":"1559-6834","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,7,22]]}}}