Anesthesia in patients with infectious disease caused by multi-drug resistant bacteria

Area of Science:

• Infection Control
• Anesthesiology
• Microbiology

Background:

• Multi-drug resistant organisms (MDROs) are prevalent in healthcare settings, with up to 50% of certain bacterial strains exhibiting resistance.
• Anesthesiologists play a role in managing patients carrying or at risk of carrying MDROs, potentially impacting transmission within the Operating Room (OR).

Purpose of the Study:

• To highlight the critical role of anesthesiologists in preventing MDRO transmission within the OR.
• To emphasize the need for including anesthesia providers in discussions and strategies for managing patients with or at risk of MDROs.

Main Methods:

• Review of current literature and outbreak investigations implicating anesthesiologists and their environment in MDRO transmission.
• Analysis of contamination sources and procedural gaps in anesthesia practice related to MDROs.
• Evaluation of infection control interventions and training needs for anesthesia staff.

Main Results:

• Anesthesia providers, equipment, and the OR environment (ventilation circuits, non-disposable equipment, workstations) have been identified as potential sources of MDRO transmission.
• Inadequate decontamination procedures and lack of training in sterile drug management contribute to MDRO spread.
• Current practices may not sufficiently address the risks associated with MDRO carriers in the perioperative setting.

Conclusions:

• Anesthesia providers must be integral to developing and implementing infection control strategies for MDRO carriers.
• Formal training in sterile drug handling and identification of at-risk patients is essential for anesthesia staff.
• Enhanced environmental cleaning methods (e.g., UV irradiation) and consideration of adjuvant therapies may further reduce MDRO transmission.