scholarly journals The experience of infection prevention for coronavirus disease 2019 (COVID-19) during general anesthesia in an epidemic of COVID-19: including unexpected exposure case - Two cases report -

2020 ◽  
Vol 15 (3) ◽  
pp. 388-396
Author(s):  
Hyunkyum Kim ◽  
Jeongmin Oh ◽  
Sang-Gon Lee ◽  
Kwang-Seok Shim

Background: Coronavirus disease 2019 (COVID-19) has been an epidemic in the Republic of Korea since the first patient who came in China was confirmed as having the disease on January 19, 2020. Therefore, surgery for COVID-19-related patients is expected to increase.Case: We experienced two cases of COVID-19-related patients who underwent surgery for femur fracture under general anesthesia. In one case, infection control to prevent transmission was achieved, while in the second case, healthcare workers were exposed to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2).Conclusions: In areas where there is COVID-19 epidemic, SARS-CoV-2 RT-PCR should be performed before surgery in patients with symptoms of respiratory infection such as fever, cough, and sputum, or for those in whom the possibility of COVID-19 cannot be completely excluded. Efforts should be made to prevent healthcare worker’s exposure and the contamination of the operating room.

2004 ◽  
Vol 100 (6) ◽  
pp. 1394-1398 ◽  
Author(s):  
Victor Wei Ter Chee ◽  
Mark Li-Chung Khoo ◽  
Sow Fong Lee ◽  
Yeow Choy Lai ◽  
Ngek Mien Chin

Background Singapore reported its first case of Severe Acute Respiratory Syndrome (SARS) in early March 2003 and was placed on the World Health Organization's list of SARS-affected countries on March 15, 2003. During the outbreak, Tan Tock Seng Hospital was designated as the national SARS hospital in Singapore to manage all known SARS patients. Stringent infection control measures were introduced to protect healthcare workers and control intrahospital transmission of SARS. Work-flow processes for surgery were extensively modified. Methods The authors describe the development of infection control measures, the conduct of surgical procedures, and the management of high-risk procedures during the SARS outbreak. Results Forty-one operative procedures, including 15 high-risk procedures (surgical tracheostomy), were performed on SARS-related patients. One hundred twenty-four healthcare workers had direct contact with SARS patients during these procedures. There was no transmission of SARS within the operating room complex. Conclusions Staff personal protection, patient risk categorization, and reorganization of operating room workflow processes formed the key elements for the containment of SARS transmission. Lessons learned during this outbreak will help in the planning and execution of infection control measures, should another outbreak occur.


2007 ◽  
Vol 28 (11) ◽  
pp. 1275-1283 ◽  
Author(s):  
A. Shigayeva ◽  
K. Green ◽  
J. M. Raboud ◽  
B. Henry ◽  
A. E. Simor ◽  
...  

Objective.To assess factors associated with adherence to recommended barrier precautions among healthcare workers (HCWs) providing care to critically ill patients with severe acute respiratory syndrome (SARS).Setting.Fifteen acute care hospitals in Ontario, CanadaDesign.Retrospective cohort study.Patients.All patients with SARS who required intubation during the Toronto SARS outbreak in 2003.Participants.HCWS who provided care to or entered the room of a SARS patient during the period from 24 hours before intubation until 4 hours after intubation.Methods.Standardized interviews were conducted with eligible HCWs to assess their interactions with the SARS patient, their use of barrier precautions, their practices for removing personal protective equipment, and the infection control training they received.Results.Of 879 eligible HCWs, 795 (90%) participated. In multivariate analysis, the following predictors of consistent adherence to recommended barrier precautions were identified: recognition of the patient as a SARS case (odds ratio [OR], 2.5 [95% confidence interval {CI}, 1.5-4.5); recent infection control training (OR for interactive training, 2.7 [95% CI, 1.7-4.4]; OR for passive training, 1.7 [95% CI, 1.0-3.0]), and working in a SARS unit (OR, 4.0 [95% CI, 1.8-8.9]) or intensive care unit (OR, 4.3 [95% CI, 2.0-9.0]). Two factors were associated with significantly lower rates of consistent adherence: the provision of care for patients with higher Acute Physiology and Chronic Health Evaluation (APACHE) II scores (OR for score APACHE II of 20 or greater, 0.4 [95% CI, 0.28-0.68]) and work on shifts that required more frequent room entry (OR for 6 or more entries per shift, 0.5 [95% CI, 0.32-0.86]).Conclusions.There were significant deficits in knowledge about self-protection that were partially corrected by education programs during the SARS outbreak. HCWs' adherence to self-protection guidelines was most closely associated with whether they provided care to patients who had received a definite diagnosis of SARS.


2005 ◽  
Vol 26 (2) ◽  
pp. 134-137 ◽  
Author(s):  
Susan M. Poutanen ◽  
Mary Vearncombe ◽  
Allison J. McGeer ◽  
Michael Gardam ◽  
Grant Large ◽  
...  

AbstractObjective:The four hospitals assessed in this study use active surveillance cultures for methicillin-resistantStaphylococcus aureus(MRSA) and contact precautions for MRSA-positive patients as part of routine infection control practices. The objective of this study was to determine whether nosocomial acquisition of MRSA decreased in these hospitals during an outbreak of severe acute respiratory syndrome (SARS) when barrier precautions were routinely used for all patients.Design:Retrospective cohort study.Setting:Three tertiary-care hospitals (a 1,100-bed hospital; a 500-bed hospital; and an 823-bed hospital) and a 430-bed community hospital, each located in Toronto, Ontario, Canada.Patients:All admitted patients were included.Results:The nosocomial rate of MRSA in all four hospitals combined during the SARS outbreak (3.7 per 10,000 patient-days) was not significantly different from that before (4.7 per 10,000 patient-days) or after (3.4 per 10,000 patient-days) the outbreak (P= .30 andP= .76, respectively). The nosocomial rate of MRSA after the outbreak was significantly lower than that before the outbreak (P= .003). Inappropriate reuse of gloves and gowns and failure to wash hands between patients on non-SARS wards were observed during the outbreak. Increased attention was paid to infection control education following the outbreak.Conclusions:Inappropriate reuse of gloves and gowns and failure to wash hands between patients may have contributed to transmission of MRSA during the SARS outbreak. Attention should be paid to training healthcare workers regarding the appropriate use of precautions as a means to protect themselves and patients.


2021 ◽  
Vol 15 (1) ◽  
pp. 64-70
Author(s):  
Ali AlAhdal ◽  
Haila Al-Huraishi ◽  
Ahmad Almalag ◽  
Adel Alrusayes ◽  
Saud M Orfali

Objective: Novel newly discovered coronavirus, also known as severe acute respiratory syndrome coronavirus-2, is a recently emerging virus that has been rapidly spreading globally since December 2019. Due to the vicinity inoro-dental treatment and aerosol production, people inside the dental office are at high risk of being infected with severe acute respiratory syndrome coronavirus-2. This guideline aims to protect the dental health-care workers during their plans to re-open and increasingly continue their routine services until further notice from their governing body. Methods: A panel of experts in dentistry and infection prevention and control reviewed the local and global research and guidelines related to infection prevention and control during coronavirus disease-2019, along with the re-opening guidance provided by different entities. Results: Such a document might either be adopted or adapted to any regional and international organization that wishes to use a revised professional guideline in infection prevention and control dental services. Conclusion: A careful re-opening plan should be developed and implemented, including strict infection control measures before resuming the dental practice.


Author(s):  
Marwa Ahmed Abdelwahab ◽  
Eman Abdel Raheem Labah ◽  
Laila Mahmoud Sayed ◽  
Mohamed Mokhtar Elbedwey ◽  
Heba Mohamed Gabr

Objective: Infection is a leading cause of hospitalization and the second most common cause of mortality among hemodialysis (HD) patients. The aim of this study is to assess the impact of infection prevention and control education program on improving healthcare workers knowledge, attitude and practices and reducing incidence of infection in the hemodialysis unit. Methodology: All patients and healthcare workers in the unit within the study period were included. This study was conducted through 3 phases; Phase I: base line survey for assessment of infection prevention and control knowledge, attitude and practices among healthcare workers, Phase II: Intervention that included infection control standardized education program followed by post education survey. Phase III: Implementation of infection control program was done associated with assessment of blood born viruses (HCV, HBV & HIV) and monitoring patients for fever and/or local signs of inflammation at catheter exit or at skin around shunt to be subjected to blood culture. Results: Health care workers knowledge, attitude and practices of infection prevention and control before intervention were unsatisfactory followed by significant improvement reflecting the effectiveness of such interventions. Regarding incidence of infection there were three cases of blood stream infections; two of them were multidrug resistant organisms (MDROs) and no reported cases of seroconverion for HIV, HCV or HBV during study period.  Conclusion: Lack of knowledge about infection prevention and control practices in hemodialysis unit could be significantly improved by standardized education program which results in reducing incidence of infections in such units.


Author(s):  
Kinjal Patel ◽  
Suraj Purusottaman ◽  
Trupti Carval ◽  
Lekhan Narvekar

Background: Infection control practices played a major role in prevention of SARS-CoV-2 in healthcare settings. Aim of the study was to know the compliance to infection control and prevention practices by healthcare workers in COVID-19 pandemic and the measures taken for prevention of SARS-CoV-2 spread in the hospital.Methods: An observational study was conducted at tertiary care hospital for a period of one month. All healthcare workers involved in patient care of COVID-19 and non COVID-19 was observed for their infection control practices. Areas were divided in two category, intensive care unit and indoor wards for audit. Environmental samples of various surfaces from intensive care unit and wards were taken and analyzed for the presence of SARS-CoV-2 RNA by reverse transcriptase polymerase chain reaction.Results: Overall compliance to infection prevention practices were improved during pandemic. Hand hygiene compliance in intensive care unit and indoor wards of COVID-19 unit were 78.66% and 74.36% whilst in non COVID-19 units was 72.47% and 62.31% respectively. Compliance to revised biomedical waste (BMW) policy at COVID-19 unit were 85.20% and 71.49% in intensive care unit and ward respectively. However, at non COVID-19 unit, it was 65.22% and 57.60%. Nursing station and doffing area of ICU at non-COVID-19 unit showed presence of SARS-CoV-2 virus. While all samples collected from COVID-19 unit were negative.Conclusions: Infection prevention and control practices play a key role to curtail transmission of infection. Awareness among healthcare workers, hospital environment, and usage of personal protective equipment should be optimized even at non COVID-19 facility.


Author(s):  
Ahmed Fouad Bogari ◽  
Nada Mohmmad Alharbi ◽  
Mohammed Abdulrahman Alaqlan ◽  
Turki Salem Aljaza ◽  
Ali Ibrahim Alibrahim ◽  
...  

The COVID-19 pandemic has forced many countries to pose an emergency to contain the contamination and prevent the further spread of the infection. In this context, many societies and research papers were published to optimize guidelines and protocols for patients undergoing surgery and subsequent intubation. Accordingly, infection control is a critical approach to reduce the rate of contamination and risk of catching infections for suspected and confirmed COVID-19 patients. As a result, various guidelines were discussed in the current literature review, including guidelines to the patient, healthcare workers, operating room, anesthesia equipment, and patient transportation. For instance, healthcare workers can protect themselves from catching infections by wearing personal protective equipment and conducting adequate disinfection measures following each operation, in addition to the proper disposal of the contaminated objects. Strictly following these protocols should be done to reduce the risk of contamination in the operating room and enhance the outcomes of the patients and healthcare workers.


2020 ◽  
pp. 1-2
Author(s):  
Tarunya Vishwanath ◽  
Shalini Arumugam ◽  
Sathish. R ◽  
Anitha Logaranjini ◽  
Prashanthi Prashanthi

Coronavirus disease 2019 (COVID-19) now called the severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) was first identified in Wuhan city, Hubei province, China. Currently RT-PCR using nasopharyngeal and Oropharyngeal swabs is supposed to be the most efficacious and standard technique for COVID testing, but are invasive and have a few drawbacks due to which, saliva as a diagnostic specimen is proposed. Salivary specimen collection is non-invasive and can be self-collected at any time and repeatedly and greatly minimises the exposure of. healthcare workers to COVID-19.


2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S349-S349
Author(s):  
Amanda Novack

Abstract Background Brucellosis is the most common laboratory-acquired bacterial infection, according to the Centers for Disease Control and Prevention (CDC), despite the rare incidence of Brucellosis in the population at large. A 34-year-old man presented with pain and swelling of the left leg, where he had previously sustained an open tibia fracture 1 year prior. After the initial injury, he underwent four corrective surgeries (including bone graft and internal-fixation) and was asymptomatic for 6 months before these new symptoms developed. MRI revealed a 6.5 × 5.1 × 2.7 cm abscess and tibial osteomyelitis. Surgical staff performed an aggressive incision and drainage (I&D) with saucerization of the tibia, to treat what seemed to be a routine hardware infection. Five days later, tissue cultures grew Brucella melitensis. Upon further questioning, the patient described butchering a wild boar 10 days prior to symptom onset. Methods The CDC provides guidance on serological testing and post-exposure prophylaxis (PEP) for persons exposed to Brucella in the laboratory setting. Upon identification of this patient’s Brucella isolates, infection control staff identified all laboratory workers that met CDC criteria for “high risk” exposure, as well as other healthcare workers (HCW) exposed to aerosolized infectious material (including those workers in the operating room during pulse lavage of the abscess). Results Staff identified 34 HCW with presumed high-risk exposure, including 19 laboratory personnel, 13 operating room personnel, and two patient care technicians. Baseline serology was obtained on all 34 HCW, and PEP with rifampin and doxycycline was prescribed for each. Nine of the exposed employees changed PEP therapy due to intolerance, and follow-up serology was obtained on 32 of the 34 healthcare workers, with zero seroconversions found. Conclusion Brucellosis is a rare disease in clinical practice, so a high index of suspicion is necessary to enact appropriate precautions before widespread exposures. When exposure is identified after the fact, efficient protocols should be in place to identify all susceptible individuals. Due to the low infectious dose of Brucella melitensis, CDC guidance should be expanded to include aerosolizing procedures outside of the laboratory. Disclosures All authors: No reported disclosures.


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