Postexposure Prophylaxis for Deadly Bloodborne Viral Infections

Abstract

The purpose of this report is to discuss management of operating room personnel who have had occupational exposure to blood and other body fluids that might contain hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV), and human T-cell lymphotropic virus type I (HTLV-I). HBV postexposure prophylaxis includes starting hepatitis B vaccine series in any susceptible unvaccinated operating room personnel who sustain an exposure to blood or body fluid during surgery. Postexposure prophylaxis with hepatitis B immune globulin (HBIG) is an important consideration after determining the hepatitis B antigen status of the patient. Ideally, all operating room personnel should be vaccinated with hepatitis B vaccine before they pursue their career in surgery. Immune globulin and antiviral agents (eg, interferon with or without ribavirin) should not be used for postexposure prophylaxis of operating room personnel exposed to patients with HCV; rather, follow-up HCV testing should be initiated to determine if infection develops. Postexposure prophylaxis for HIV involves a basic four-week regimen of two drugs (zidovudine and lamivudine; lamivudine and stavudine; or didanosine and stavudine) for most exposures. An expanded regimen that includes a third drug must be considered for HIV exposures that pose an increased risk for transmission. When developing a postexposure prophylaxis regimen, it is helpful to contact the National Clinicians' Postexposure Prophylaxis Hotline, (888) 448-4911. Prevention should be a major consideration in postexposure prophylaxis with the use of the double-glove hole indication system by all operating room personnel.

Knowledge of Aseptics and Antisepsis and Following Their Rules as Elements of Infection Prevention in the Work of Paramedics

“…Odpowiedzi udzielone przez ratowników medycznych obrazuje rycina 1. może ograniczyć występowanie zakażeń w tej grupie zawodowej (1,2). Wiedza ratowników medycznych o zakażeniach krwiopochodnych stanowi nadrzędny czynnik kształtujący ich zachowania w codziennej pracy z pacjentem.…”

“…Czas jej rozpoczęcia powinien być jak najwcześniejszy. Badania zagranicznych autorów wykazały, że profilaktyka poekspozycyjna najprawdopodobniej nie jest efektywna, jeśli zastosowano ją po upływie 24-36 godzin od zdarzenia (1).…”

Post-exposure immunization by capsid-modified AdC7 vector expressing Pseudomonas aeruginosa OprF clears P. aeruginosa respiratory infection

“…Therefore, a therapeutic vaccine to clear P. aeruginosa colonization would be an attractive strategy. Most therapeutic vaccines have been developed against viruses such as rabies [24], ebola [25, 26], varicella [27], human immunodeficiency virus, hepatitis B and hepatitis C [28]. Bacterial targets have been mainly Mycobacterium spps [29].…”