Fecal Patina in the Anesthesia Work Area

Munoz-Price, L. Silvia; Weinstein, Robert A.

doi:10.1213/ane.0000000000000542

Cited by 17 publications

(8 citation statements)

References 25 publications

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“…While anesthesia providers have not traditionally considered themselves to be on the front lines of infection prevention, we have learned in recent years that organisms acquired in the hospital setting can originate from the anesthesia workplace and from the hands of anesthesia providers. 7,8 In 2018, a writing group of the Society for Healthcare Epidemiology of America (Arlington, Virginia) published an expert guidance with recommendations for preventing transmission of pathogens in the anesthesia workplace. 9 The group recognized the difficulty of cleaning the anesthesia workplace, especially the anesthesia machine and the anesthesia cart, in the short time typically allowed for turnover of an operating room.…”

Section: Preventing Infection Of Patients and Healthcare Workers Shoumentioning

confidence: 99%

Preventing Infection of Patients and Healthcare Workers Should Be the New Normal in the Era of Novel Coronavirus Epidemics

Bowdle

Muñoz-Price

2020

Anesthesiology

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Section: Preventing Infection Of Patients and Healthcare Workers Shoumentioning

confidence: 99%

Preventing Infection of Patients and Healthcare Workers Should Be the New Normal in the Era of Novel Coronavirus Epidemics

Bowdle

Muñoz-Price

2020

Anesthesiology

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“…Inadvertent contamination of anesthesiology workspaces, including medication preparation areas, has been clearly demonstrated. [26][27][28][29][30][31] In this environment, it is possible that a healthcare provider could unknowingly contaminate the rubber diaphragm of a medication vial with bodily fluids containing viral particles when caring for a hepatitis C virus-infected patient (many of whom are unaware of their hepatitis C virus status). If the contaminated vial is then used for additional patients, it is plausible that hepatitis C virus could be transmitted from the outer vial diaphragm into the medication itself, despite the use of a new sterile syringe and needle for each vial entry.…”

Section: Perioperative Medicinementioning

confidence: 99%

Hepatitis C Contamination of Medication Vials Accessed with Sterile Needles and Syringes

et al. 2019

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Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New Background Health care–associated hepatitis C virus outbreaks from contaminated medication vials continue to be reported even though most practitioners deny reusing needles or syringes. The hypothesis was that when caring for hepatitis C virus–infected patients, healthcare providers may inadvertently contaminate the medication vial diaphragm and that subsequent access with sterile needles and syringes can transfer hepatitis C virus into the medication, where it remains stable in sufficient quantities to infect subsequent patients. Methods A parallel-arm lab study (n = 9) was performed in which contamination of medication vials in healthcare settings was simulated using cell culture–derived hepatitis C virus. First, surface-contaminated vials were accessed with sterile needles and syringes, and then hepatitis C virus contamination was assessed in cell culture. Second, after contaminating several medications with hepatitis C virus, viral infectivity over time was assessed. Last, surface-contaminated vial diaphragms were disinfected with 70% isopropyl alcohol to determine whether disinfection of the vial surface was sufficient to eliminate hepatitis C virus infectivity. Results Contamination of medication vials with hepatitis C virus and subsequent access with sterile needles and syringes resulted in contamination of the vial contents in sufficient quantities to initiate an infection in cell culture. Hepatitis C virus remained viable for several days in several commonly used medications. Finally, a single or 2- to 3-s wipe of the vial diaphragm with 70% isopropyl alcohol was not sufficient to eliminate hepatitis C virus infectivity. Conclusions Hepatitis C virus can be transferred into commonly used medications when using sterile single-use needles and syringes where it remains viable for several days. Furthermore, cleaning the vial diaphragm with 70% isopropyl alcohol is not sufficient to eliminate the risk of hepatitis C virus infectivity. This highlights the potential risks associated with sharing medications between patients.

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“…The adjustable pressure limiting (APL) valves, gas flowmeters, and the agent vaporizer dials of the anesthesia machine are common reservoirs for enterococci and other pathogenic bacterial species [ 2 – 11 ]. Institutional cleaning protocols vary widely and are ineffective in eliminating pathogenic contamination, leading some infection control epidemiologists to refer to the “fecal patina in the anesthesia work area” [ 6 ]. In the range of operative settings nationwide, there is likely great variability in cleaning practices.…”

Section: Introductionmentioning

confidence: 99%

“…Pathogenic microorganisms are known to survive on the anesthesia machine after standardized, routine cleaning, with bacterial burden reduced but not eliminated, even after accelerated cleaning practices are initiated [ 5 – 8 ]. In simulations, we and others have demonstrated that routine, between-case cleaning is inadequate in removing a fluorescent marker serving as a surrogate pathogen, the inoculum persisting as a potential infection source for a subsequently cared-for patient [ 6 – 9 ]. Current best cleaning practices fail in achieving full decontamination and thus may place subsequent patients at considerable risk of cross contamination.…”

Section: Introductionmentioning

confidence: 99%

Assessing a Novel Method to Reduce Anesthesia Machine Contamination: A Prospective, Observational Trial

Biddle

George-Gay

Prasanna

et al. 2018

Canadian Journal of Infectious Diseases and Medical Microbiolog

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Background Anesthesia machines are known reservoirs of bacterial species, potentially contributing to healthcare associated infections (HAIs). An inexpensive, disposable, nonpermeable, transparent anesthesia machine wrap (AMW) may reduce microbial contamination of the anesthesia machine. This study quantified the density and diversity of bacterial species found on anesthesia machines after terminal cleaning and between cases during actual anesthesia care to assess the impact of the AMW. We hypothesized reduced bioburden with the use of the AMW. Methods In a prospective, experimental research design, the AMW was used in 11 surgical cases (intervention group) and not used in 11 control surgical cases. Cases were consecutively assigned to general surgical operating rooms. Seven frequently touched and difficult to disinfect “hot spots” were cultured on each machine preceding and following each case. The density and diversity of cultured colony forming units (CFUs) between the covered and uncovered machines were compared using Wilcoxon signed-rank test and Student's t-tests. Results There was a statistically significant reduction in CFU density and diversity when the AMW was employed. Conclusion The protective effect of the AMW during regular anesthetic care provides a reliable and low-cost method to minimize the transmission of pathogens across patients and potentially reduces HAIs.

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Fecal Patina in the Anesthesia Work Area

Cited by 17 publications

References 25 publications

Preventing Infection of Patients and Healthcare Workers Should Be the New Normal in the Era of Novel Coronavirus Epidemics

Preventing Infection of Patients and Healthcare Workers Should Be the New Normal in the Era of Novel Coronavirus Epidemics

Hepatitis C Contamination of Medication Vials Accessed with Sterile Needles and Syringes

Assessing a Novel Method to Reduce Anesthesia Machine Contamination: A Prospective, Observational Trial

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