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Published on: June 15, 2019
Sepsis, parenteral vaccination and skin disinfection
1a University of Newcastle , Callaghan , New South Wales , Australia.
Abstract:
ASBSTRACT Disinfection should be required for all skin penetrative procedures including parenteral administration of vaccines. This review analyses medically attended infectious events following parenteral vaccination in terms of their microbiological aetiology and pathogenesis. Like 'clean' surgical site infections, the major pathogens responsible for these events were Staphylococcal species, implicating endogenous con-tamination as a significant source of infection. As 70% isopropyl alcohol swabbing has been shown to effectively disinfect the skin, it would be medico-legally difficult to defend a case of sepsis with the omission of skin disinfection unless the very low risk of this event was adequately explained to the patient and documented prior to vaccination. There was a significant cost-benefit for skin disinfection and cellulitis. Skin disinfection in the context of parenteral vaccination represents a new paradigm of medical practice; the use of a low cost intervention to prevent an event of very low prevalence but of significant cost.
Insights
Skin disinfection is crucial for all procedures involving skin penetration, including vaccinations. Using 70% isopropyl alcohol prevents infections, reduces costs, and is medically recommended.
Area of Science:
- Infectious Diseases
- Medical Microbiology
- Public Health
Background:
- Parenteral vaccination involves skin penetration, posing a risk of infection.
- Medically attended infectious events post-vaccination require analysis of causative agents and transmission routes.
- Staphylococcal species are identified as primary pathogens in post-vaccination infections, similar to surgical site infections.
Purpose of the Study:
- To review and analyze infectious events following parenteral vaccination.
- To determine the microbiological etiology and pathogenesis of these infections.
- To evaluate the necessity and cost-effectiveness of skin disinfection prior to vaccination.
Main Methods:
- Literature review of medically attended infectious events after parenteral vaccination.
- Analysis of microbiological data and etiological factors.
- Assessment of the efficacy of 70% isopropyl alcohol for skin disinfection.
Main Results:
- Staphylococcal species are the predominant pathogens causing infections after parenteral vaccination.
- Endogenous contamination is a significant source of infection.
- 70% isopropyl alcohol effectively disinfects the skin, reducing infection risk.
- Omitting skin disinfection presents medico-legal challenges unless risks are clearly communicated and documented.
- Skin disinfection demonstrates a significant cost-benefit by preventing costly infections like cellulitis.
Conclusions:
- Skin disinfection is a necessary measure for all parenteral procedures, including vaccinations.
- Implementing 70% isopropyl alcohol swabbing is a low-cost intervention with substantial benefits.
- This practice represents a new standard in medical care, preventing rare but costly infectious events.
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