Bacterial contamination of cystic fibrosis clinics

Abstract

Respiratory pathogens from CF patients can contaminate their hands and the clinic environment, but the actual risk of patient-to-patient transmission in the outpatient setting remains difficult to quantify. These findings support several recommendations CF infection control recommendations including hand hygiene for staff and patients, contact precautions for certain pathogens, and disinfecting equipment and surfaces touched by patients and staff.

Infection Prevention and Control Guideline for Cystic Fibrosis: 2013 Update

“…125 Factors associated with generating infectious droplets of P. aeruginosa are unknown, as exacerbations, sick versus well CF clinic visits, or age were not predictive. 125,128 We emphasize that none of these observational studies were associated with person-to-person transmission, but such data provide evidence of the potential for such transmission and, thus, the importance of implementing strategies to prevent droplet transmission. Furthermore, as previously described the potential for transmission of M. abscessus by droplets or droplet nuclei has been suggested, 66,129 but to our knowledge no studies to date have demonstrated the specific route(s) of NTM transmission among people with CF.…”

“…5,[327][328][329] In healthcare facilities that deliver care to people with CF, contamination of dry environmental surfaces with CF pathogens was low, but contamination of the hands of people with CF was higher. 128 In a Liverpool CF center, contamination of inanimate surfaces was transient and negative after patient discharge and routine cleaning. 127 Similar findings have been noted in other CF clinics.…”

“…127 Similar findings have been noted in other CF clinics. 128,317 Healthcare equipment. Contamination of medical equipment is another potential source of pathogens for people with CF.…”

“…331 In CF settings, 26 stethoscopes used in a clinic were not found to be contaminated with CF pathogens, 332 and in a more recent study P. aeruginosa and S. aureus were rarely recovered from stethoscopes, pulse oximeters, and otoscopes. 128 Nevertheless, there is sufficient evidence to support the importance of cleaning and disinfecting medical equipment after use by one person with CF prior to use by another person with CF, according to hospital protocols.…”

“…126 Several CF pathogens (ie, P. aeruginosa, MSSA, and MRSA) were recovered from air collected 3 feet from CF subjects in exam rooms; these strains were the same as those infecting the subjects as assessed by PFGE. 128 Similarly, CF pathogens were recovered from the air 6 feet from CF subjects performing PFTs. 125 Factors associated with generating infectious droplets of P. aeruginosa are unknown, as exacerbations, sick versus well CF clinic visits, or age were not predictive.…”