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Variations in infection control practices suggest a need for guidelines in primary ciliary dyskinesia patient care
Ayse B Caliskan1, Amjad Horani1,2, Michele Manion3
1Department of Pediatrics, Division of Allergy and Pulmonary Medicine, School of Medicine, Washington University in Saint Louis, St. Louis, Missouri, USA.
Abstract:
Primary ciliary dyskinesis (PCD) is an autosomal recessive disorder associated with impaired mucociliary clearance caused by defects in ciliary structure and function. The major clinical feature of PCD is recurring or persistent respiratory tract infection. Respiratory tract colonization with drug-resistant organisms impacts the frequency of infections and lung function decline. Protective gear has been employed by caregivers in an attempt to control respiratory tract bacterial spread between patients with cystic fibrosis, but use in PCD is not known. We conducted a web-based survey to investigate infection control and prevention practices of PCD centers in North America, and how practices have been influenced by the COVID-19 pandemic. The response rate was 87.0%. Before the COVID-19 pandemic, glove, gown, and mask use were variable, and only 3.7% of centers used masks during encounters with PCD outpatients. After COVID-19 mandates are lifted, 48.1% of centers plan to continue to use masks during outpatient care, while the practice regarding the use of gloves and gowns was not influenced by the current pandemic. There is no uniform practice for infection control in PCD care indicating the need for practice guidelines. Mitigation of respiratory virus transmission learned during the COVID-19 pandemic may impact future infection control approaches used for patients with PCD and other lung diseases.
Insights
Infection control practices for Primary Ciliary Dyskinesia (PCD) vary significantly among North American centers. The COVID-19 pandemic has increased mask use in outpatient settings, highlighting a need for standardized PCD care guidelines.
Area of Science:
- Pulmonology
- Infectious Disease Control
- Genetics
Background:
- Primary ciliary dyskinesia (PCD) is a genetic disorder impairing mucociliary clearance, leading to recurrent respiratory infections.
- Drug-resistant organisms exacerbate infection frequency and lung function decline in PCD patients.
- Current infection control practices in PCD care are not standardized, with limited data on protective gear usage.
Purpose of the Study:
- To investigate current infection control and prevention strategies in North American PCD centers.
- To assess the impact of the COVID-19 pandemic on these practices.
- To identify the need for standardized infection control guidelines in PCD management.
Main Methods:
- A web-based survey was distributed to PCD centers across North America.
- The survey collected data on infection control practices before and after the COVID-19 pandemic.
- A high response rate of 87.0% ensured robust data collection.
Main Results:
- Pre-pandemic, the use of gloves, gowns, and masks in PCD care was inconsistent, with only 3.7% of centers using masks for outpatients.
- Post-pandemic, 48.1% of centers plan to continue mask use during outpatient visits.
- Practices regarding glove and gown use were not significantly influenced by the pandemic.
Conclusions:
- Significant variability exists in infection control measures for Primary Ciliary Dyskinesia, underscoring the need for evidence-based guidelines.
- Lessons learned from the COVID-19 pandemic regarding respiratory virus transmission mitigation may inform future PCD infection control strategies.
- Standardized protocols are essential to improve patient outcomes and prevent the spread of infections in PCD care settings.
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