Cross‐infection from contaminated anaesthetic equipment

Abstract

SummaryA definite relationship between the use of contaminated anaesthetic equipment and subsequent pulmonary infection remains to be established. There is however indirect and circumstantial evidence suggesting that cross-infection may occur, and further an increased susceptibility of surgical patients to pulmonary infections has been demonstrated. Decontamination should be recommended bejore the equipment is re-used. Pasteurisation may protie sufficient and this can be obtained employing a specially designed dish-washing machine.

Hygienic practices of consultant anaesthetists: a survey in the North‐West region of the UK

“…The filter was changed between cases by 7.2% of the respondents in the present study, but it is likely that, in the year since the study was undertaken, the use of bacterial filters has increased. It has been shown that anaesthetic breathing systems can become contaminated with organisms from the respiratory tract, especially with coughing [25–28]. It is recommended that either an appropriate filter should be placed between the patient and the breathing system, with a new filter being used for each patient, or that a new breathing system be used for each patient, especially in paediatric practice [3].…”

Anaesthetic Machine and Breathing System Contamination and the Efficiacy of Bacterial/Viral Filters

“…An increasing awareness of the complexity of patients presenting for anaesthesia or ventilation in an intensive care environment is crucial to modern practice. Surgery is associated with alterations in cellmediated and humoral immunity 49,50 which may be accentuated by the clinical state of the patient and medications 41 . The use of oxygen at concentrations greater than 21% results in depression of alveolar macrophage function 26 .…”

“…There is a paucity of evidence involving other infective agents. However, as Nielson et al 41 conclude, most work indicates that cross-infection could occur, and that surgical patients have increased susceptibility to infection anyway. Given the lack of information about infection by viral agents it cannot be argued that the anaesthetic and breathing circuit pose a minimal infectious hazard to the patient.…”

An investigation of the bacterial contamination of small animal breathing systems during routine use

“…They are usually made of corrugated semi-disposable plastic tubing, which makes them prone to the retention of micro-organisms (Murphy et al 1991). If pathogenic bacteria can survive in anaesthesia breathing systems, and if they can be eluted in the fresh gas flow, then the potential for cross-contamination exists (Nielsen et al 1980;Langevin et al 1999). Previous reports have stated that there is a risk of bacterial transmission through anaesthetic equipment (Phillips & Spencer 1965;Beck & Zadeh 1968;Olds et al 1972) but many failed to provide a proof of causation (Albrecht & Dryden 1974).…”