An investigation of the clinic where the patient received prolotherapy indicated several infection control breaches, including the use of a used syringe to reenter a multidose medication vial, the use of single-dose medication vials for multiple patients, lack of aseptic technique, and poor hand hygiene, including inconsistent glove use. The clinic was advised on appropriate handling of injectables in order to reduce bloodborne pathogen transmission but after a subsequent visit revealed ongoing poor infection control practices, health officials ordered the clinic to close its doors. 

In addition to the patient in this case, six other patients who frequented the clinic were identified as having HCV infection, five of whom were unaware of their status. Four of the patients, who had no prior HCV diagnosis or risk factors for HCV, had injections performed at the clinic the same day as the index patient; no new HBV or HIV infections were found after a thorough investigation.

All healthcare settings where injections occur should have guidelines for safe injection practices. Although hospitals have established infection control protocols, clinics that perform CAM therapies where injectables are used may not. The authors end by saying that these types of healthcare settings may benefit from infection control training and should be included in healthcare-associated surveillance networks.

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