A state health investigation found 25 of 49 outpatient surgical centers in Nevada had infection control deficiencies similar to those blamed for an outbreak of hepatitis C last year in Las Vegas.

A draft report found inappropriate use of single-use items such as syringes accounted for nearly one-third of infection-control problems identified in fiscal 2008, and that sterilization and disinfection issues accounted for almost half.

Marla McDade Williams, chief of the state's Bureau of Health Care Quality and Compliance, called it a concern that regulations weren't being followed. She said stepped-up inspections by staff surveyors would reinforce the regulations for ambulatory surgical centers.

"We want them to know far more frequently that there are state standards that they must adhere to," Williams said.

The division, formerly known as Licensure and Certification, has 34 surveyors and 14 supervisors who do inspections of nursing homes, ambulatory surgery clinics, group homes and hospitals. Williams said adding 11 surveyors would allow inspections of all 1,100 state-licensed facilities every 18 months.

She said money for more surveyors could come from increased licensing fees collected from the facilities.

Williams said that in the past, state surveyors spent 70 percent of their time with facilities such as nursing homes that the federal Centers for Medicare and Medicaid Services pay Nevada to certify and inspect.

The report, issued Friday, didn't identify which surgical centers not connected to the hepatitis outbreak investigation had deficiencies.

Nevada State Health Division spokeswoman Martha Framsted said that by summer, all health care surveys will be posted on a Web site for the public to examine.

Health officials advised some 50,000 Las Vegas-area patients in February 2008 to get tested for exposure to hepatitis C, after inspectors reported finding doctors and nurses had been reusing syringes and vials of anesthesia at two now-closed outpatient endoscopy centers.

The effort represented the largest patient notification in U.S. history

Nine people were found to have contracted the debilitating and incurable liver virus, and health authorities identified another 105 cases of hepatitis C that may have been linked to the clinics.

The public health crisis has spawned more than 100 lawsuits, and several bills are now under consideration by the Nevada Legislature.