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Infectious diseases in the operating room
1Anesthesia Services, Washington Hospital, 155 Wilson Avenue, Washington, PA 15301, USA.
Abstract:
Patients with infectious diseases have special implications for infection control in the operating room. The increased use and abuse of antibiotics has ushered in a category of resistant organisms. These multiresistant organisms are spread by direct or indirect contact, primarily from the hands of caregivers or contact with contaminated environmental surfaces. Another category of infectious diseases is prions (pronounced pree-ons). Unlike other infectious diseases, human prions diseases are not spread through routine exposures such as direct contact, droplet, and airborne routes. The causative agent is highly resistant to traditional disinfecting and sterilization processes. This article provides an overview of the multiresistant infections of methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, and Staphylococcus aureus with reduced susceptibility to vancomycin along with the human prions diseases Creutzfeldt-Jakob disease, German-Straüssler-Scheinker syndrome, kuru, and fatal familial insomnia. We provide a template of precautions that can be used in developing operating room and anesthesia infection control protocols for this patient population.
Insights
Operating rooms need special infection control for patients with multidrug-resistant organisms and prion diseases. This overview details resistant infections and prion diseases, offering a protocol template for enhanced safety.
Area of Science:
- Infectious Diseases
- Microbiology
- Neurology
Background:
- Antibiotic resistance has led to multidrug-resistant organisms (MDROs) like MRSA and VRE.
- Prion diseases, such as Creutzfeldt-Jakob disease, present unique challenges due to agent resistance to sterilization.
- Both MDROs and prion diseases require specific infection control strategies in healthcare settings.
Purpose of the Study:
- To provide an overview of key multidrug-resistant infections and human prion diseases.
- To highlight the unique transmission and resistance characteristics of these pathogens.
- To offer a template for developing operating room and anesthesia infection control protocols.
Main Methods:
- Literature review and synthesis of information on MDROs and prion diseases.
- Identification of common resistant organisms: methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), and Staphylococcus aureus with reduced vancomycin susceptibility.
- Overview of human prion diseases: Creutzfeldt-Jakob disease, German-Straüssler-Scheinker syndrome, kuru, and fatal familial insomnia.
- Development of a precautionary template for operating room and anesthesia infection control.
Main Results:
- MDROs spread via contact (caregivers, surfaces); prion diseases do not spread through routine exposure routes.
- Prion disease agents are highly resistant to standard disinfection and sterilization methods.
- A template for infection control protocols addressing these specific patient populations is presented.
Conclusions:
- Effective infection control in operating rooms requires tailored strategies for patients with MDROs and prion diseases.
- Understanding the distinct transmission and resistance profiles is crucial for preventing healthcare-associated infections.
- The provided protocol template can guide the development of enhanced safety measures in surgical environments.