Transmission of Bacterial Infections to Healthcare Workers during Intubation and Respiratory Care of Patients with Severe Pneumonia

Baba, Hisashi; Iinuma, Yoshitsugu; Imaizumi, Kazuyoshi; Hasegawa, Yoshinori; Hasegawa, Tadao; Ohta, Michio; Paterson, David L.

doi:10.1086/606043

Cited by 14 publications

(19 citation statements)

References 10 publications

(16 reference statements)

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“…However, providers often forget or choose not to wear face protection in situations in which it is indicated. 2,3 In December 2013, our infection prevention and control department received several phone calls from unit staff after exposure to a patient with possible Neisseria meningitidis . These providers had performed open suctioning on the patient without wearing face protection, before the potential diagnosis was considered.…”

mentioning

confidence: 99%

Barriers to the use of face protection for standard precautions by health care providers

Kinlay

Flaherty

Scanlon

et al. 2015

American Journal of Infection Control

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Health care providers sometimes choose not to use face protection even when indicated as part of standard precautions. We performed a survey of pediatric health care providers to determine barriers to the routine use of face protection. Lack of availability at the point of care and a perceived lack of need were the most commonly cited issues. Continuing education is needed regarding situations in which face protection is indicated for standard precautions.

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confidence: 99%

Barriers to the use of face protection for standard precautions by health care providers

Kinlay

Flaherty

Scanlon

et al. 2015

American Journal of Infection Control

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“…Because of that, it is argued which single empirical antibiotic therapy would be correct in case of infection in a healthcare worker: empirical coverage directed to community germs or MDR bacteria? [5][6][7][8] Based on that, defining the colonization profile of healthcare workers is a matter of great importance and aims to avoid prescription of inadequate empirical antibiotic therapy, which is associated with increased morbidity and mortality (if using limited spectrum antibiotic medication to treat patients with MDR bacteria), as well as the development of antimicrobial resistance within the population and unnecessary hospitalizations (in cases of improper use of broad-spectrum antibiotics). [9][10][11][12] To corroborate the elucidation of this question, we developed this retrospective observational study aimed to identify the microbiological profile of infections in healthcare professionals who required hospitalization.…”

Section: Introductionmentioning

confidence: 99%

Microbiologic profile of hospitalized healthcare workers

Moraes¹,

Giustina

Farenzena

et al. 2014

Rev. Assoc. Med. Bras.

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Objective: according to the epidemiologic and antimicrobial resistance profile, infections are usually classified as community-acquired or nosocomial. Reports on patients without the classic criteria for nosocomial infection with multidrug--resistant germs are increasing. There is a particular concern regarding which microbiological profile must be addressed in case of infections in healthcare workers. This study was carried out with the purpose of identifying the prevalence of infection by multidrug-resistant germs in healthcare workers exposed to occupational contact with such germs at work. Methods: observational and retrospective study. In a 7-year period, healthcare worker hospitalizations were identified and the cultures results were assessed in order to identify the prevalence of infection by multidrug-resistant pathogens. Results: 1,487 healthcare workers hospitalizations were identified. In 105 of these hospitalizations, cultures were collected on the first 5 days after admission, and in 22 patients, 24 germs were identified. Multidrug-resistant pathogens were not found. Conclusion: in our sample, composed of workers from a tertiary public hospital who were hospitalized, none of the individuals presented MDR colonization or infection. These results suggest that when healthcare workers present infections, they must receive antibiotic therapy directed to community-acquired pathogens. In light of the limitations of this study, further larger and multicenter studies must be developed to enlighten such issue.

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“…4,5 Occupational transmission to healthcare workers from patients with bacterial pneumonia has also been described during respiratory care procedures that occur at close proximity. 6 When using a high frequency oscillator, expiratory gas is vented out relief valves directly into the atmosphere. Furthermore, the piston movement can lead to aerosolization of expired droplet particles.…”

Section: Introductionmentioning

confidence: 99%

Modification of a High Frequency Oscillator Circuit With a Heated Expiratory Filter to Prevent Infectious Pathogen Transmission: A Bench Study

McKeown

Serreqi

2012

Respir Care

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BACKGROUND: High frequency oscillation is a safe and effective treatment for patients with ARDS, but poses a patient and caregiver risk when the circuit is disconnected. We modified the circuit to include a heated expiratory filter, eliminating the need for daily filter changes due to buildup of condensate. The purpose of the study was to determine if substitution of the filter resulted in a clinically important change in delivered tidal volume or amplitude. We additionally compared expiratory resistance and measured efficacy for the substituted filter. METHODS: This bench study measured tidal volume and amplitude using 5 of each filter type across 6 patient setting scenarios. Filter efficacy was tested through an independent laboratory, and expiratory resistance measurements were taken after prolonged use with humidification. RESULTS: The clinically important threshold value for tidal volume (defined as 5% difference) was excluded by the limits of agreement, confirming that use of the modified circuit does not result in alterations in tidal volume. The clinically important threshold for amplitude (defined as 10% difference) was the same as the lower confidence interval on the lower limit of agreement, indicating it is possible for amplitude values to be different between the 2 filters. Filter efficacy for the substituted filter was not affected. Expiratory resistance was unchanged in the substituted filter, but nearly doubled for the manufacturer's filter after 48 hours. CONCLUSIONS: Modifying the circuit to include a heated expiratory filter does not affect tidal volume, and the filter material remains efficacious during oscillation. Amplitude varies under some conditions. Preventing the need for daily filter changes reduces the risk of alveolar de-recruitment. This does not completely eliminate exposure to expired gases, but provides an additional layer of protection against occupational exposure and nosocomial spread of respiratory pathogens. Further testing in a clinical environment is necessary.

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Transmission of Bacterial Infections to Healthcare Workers during Intubation and Respiratory Care of Patients with Severe Pneumonia

Cited by 14 publications

References 10 publications

Barriers to the use of face protection for standard precautions by health care providers

Barriers to the use of face protection for standard precautions by health care providers

Microbiologic profile of hospitalized healthcare workers

Modification of a High Frequency Oscillator Circuit With a Heated Expiratory Filter to Prevent Infectious Pathogen Transmission: A Bench Study

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