Infection Control Measures for Operative Procedures in Severe Acute Respiratory Syndrome–related Patients

Chee, Victor W. T.; Khoo, Mark L. C.; Lee, Sow Fong; Lai, Yeow Choy; Chin, Ngek Mien

doi:10.1097/00000542-200406000-00010

Cited by 144 publications

(183 citation statements)

References 7 publications

Supporting

Mentioning

167

Contrasting

Unclassified

Order By: Relevance

“…In this environment, removing airborne contaminants requires 18 minutes for 99% efficiency and 28 minutes for 99.9% efficiency 16 . Therefore, 30 minutes of room ventilation was required after aerosol forming high-risk procedures, such as endotracheal intubation or extubation 12,17 . The cleanliness level of each room was also measured using a particle counter (TSI 9310; TSI, United States): main operating room = 2,604 and the anteroom = 2,540, which were much lower than the institutional target level of <10,000 for general surgery (Fig.…”

Section: Resultsmentioning

confidence: 99%

“…Although MERS has lower human-to-human transmission potential and has resulted in fewer large outbreaks than SARS, there may be occasional amplification of clusters in healthcare settings [21][22][23] . Moreover, MERS case fatalities are reported to be much higher than SARS (35-45% for MERS and 10-15% for SARS) 12,17,23,24,26 . Unlike SARS, ongoing small and large MERS outbreaks in the Arabian Peninsula foster potential future MERS outbreaks in non-endemic countries.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Infection Prevention Measures for Surgical Procedures during a Middle East Respiratory Syndrome Outbreak in a Tertiary Care Hospital in South Korea

Park

Yoo

et al. 2020

Sci Rep

View full text Add to dashboard Cite

In 2015, we experienced the largest in-hospital Middle East respiratory syndrome (MERS) outbreak outside the Arabian Peninsula. We share the infection prevention measures for surgical procedures during the unexpected outbreak at our hospital. We reviewed all forms of related documents and collected information through interviews with healthcare workers of our hospital. After the onset of outbreak, a multidisciplinary team devised institutional MERS-control guidelines. Two standard operating rooms were converted to temporary negative-pressure rooms by physically decreasing the inflow air volume (−4.7 Pa in the main room and −1.2 Pa in the anteroom). Healthcare workers were equipped with standard or enhanced personal protective equipment according to the MERS-related patient's profile and symptoms. Six MERS-related patients underwent emergency surgery, including four MERS-exposed and two MERS-confirmed patients. Negative conversion of MERS-CoV polymerase chain reaction tests was noticed for MERS-confirmed patients before surgery. MERS-exposed patients were also tested twice preoperatively, all of which were negative. All operative procedures in MERSrelated patients were performed without specific adverse events or perioperative MERS transmission. Our experience with setting up a temporary negative-pressure operation room and our conservative approach for managing MERS-related patients can be referred in cases of future unexpected MERS outbreaks in non-endemic countries.The Middle East respiratory syndrome (MERS) is a serious acute respiratory disease caused by the MERS coronavirus (MERS-CoV), and the mortality rates in infected patients are estimated at 20-40% 1 . Since the first case report in Saudi Arabia in 2012 2 , MERS outbreaks have occurred mainly in Middle Eastern countries and a small number of imported cases arose in Europe, Asia, United States, and Africa 3-7 . From May to July 2015, South Korea experienced the largest MERS outbreak outside the Arabian Peninsula 8,9 . The South Korean outbreak resulted in 186 laboratory-confirmed MERS cases, 92 of which were associated with our tertiary care hospital 10,11 . According to our institutional policy during the MERS outbreak, all elective surgeries for MERS-related patients were postponed when possible. However, several MERS-related patients inevitably required emergency operations under anesthesia. Two of the 92-MERS confirmed cases and four MERS-exposed patients underwent surgery. Although there is some literature regarding infection prevention during operative procedures for severe acute respiratory syndrome (SARS) coronavirus 12,13 , guidelines or references for MERS prevention during perioperative patient care were very limited. Therefore, we developed institutional guidelines for perioperative MERS infection prevention and we set up a temporary negative-pressure operating room.In this globalized era, along with small and large outbreaks that persist in the Arabian Peninsula, MERS outbreaks may recur in any other regions, especially if a super spreader i...

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Infection Prevention Measures for Surgical Procedures during a Middle East Respiratory Syndrome Outbreak in a Tertiary Care Hospital in South Korea

Park

Yoo

et al. 2020

Sci Rep

View full text Add to dashboard Cite

show abstract

“…Physical modification of the ventilation system was done to minimize the outflow of contaminated air from the operating room into the rest of the operating room complex. With these key arrangements, 41 operative procedures, including 15 high-risk procedures (surgical tracheostomy), were performed on SARS patients by 124 healthcare workers in the operating room complex in Singapore, without any transmission of SARS (Chee et al, 2004).…”

Section: Infection Controlmentioning

confidence: 99%

Clinical management and infection control of SARS: Lessons learned

et al. 2013

View full text Add to dashboard Cite

The outbreak of severe acute respiratory syndrome (SARS) in 2003 was the first emergence of an important human pathogen in the 21st century. Responding to the epidemic provided clinicians with extensive experience in diagnosing and treating a novel respiratory viral disease. In this article, we review the experience of the SARS epidemic, focusing on measures taken to identify and isolate patients, prevent the transmission of infection to healthcare workers and develop effective therapies. Lessons learned from the SARS epidemic will be especially important in responding to the current emergence of another highly pathogenic human coronavirus, the agent of Middle East respiratory syndrome (MERS), and to the recently emerging H7N9 influenza A virus in China. This paper forms part of a symposium in Antiviral Research on "From SARS to MERS: 10years of research on highly pathogenic human coronaviruses."

show abstract

“…With epidemic or pandemic spread, environmental containment is also vital. In Singapore, at the height of the SARS epidemic, medical providers modified their infectioncontrol procedures to better contain nosocomial spread of the virus [14]. In addition to wearing standard PPE, providers wore disposable hats, disposable shoe covers, and positive air-powered respirators.…”

Section: Containmentmentioning

confidence: 99%

Avian flu (H5N1): its epidemiology, prevention, and implications for anesthesiology

Edler

2006

Journal of Clinical Anesthesia

View full text Add to dashboard Cite

Avian flu, influenza A subtype H5N1, is an emergent and virulent disease that poses a threat to the health and safety of the world community. Avian flu is 1 of more than 25 influenza A viruses that reside primarily in birds but also infect humans and other mammals. Avian flu is responsible for the current outbreak in Asia; H5N1 has now displayed probable human-to-human transmission; it could be a harbinger of a global epidemic. Anesthesiologists are exposed to a risk for infection when they are involved in airway instrumentation of infected patients. Given the evidence of emerging resistance to common antiviral agents used to treat H5N1 influenza virus and limited supply of H5N1 vaccine, prevention is our best protection. The following article will detail the virology and preventive public health practices for H5N1. This knowledge can also be used to define and prevent other yet unidentified infectious threats.

show abstract

Infection Control Measures for Operative Procedures in Severe Acute Respiratory Syndrome–related Patients

Cited by 144 publications

References 7 publications

Infection Prevention Measures for Surgical Procedures during a Middle East Respiratory Syndrome Outbreak in a Tertiary Care Hospital in South Korea

Infection Prevention Measures for Surgical Procedures during a Middle East Respiratory Syndrome Outbreak in a Tertiary Care Hospital in South Korea

Clinical management and infection control of SARS: Lessons learned

Avian flu (H5N1): its epidemiology, prevention, and implications for anesthesiology

Contact Info

Product

Resources

About