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Results for “Blood-Borne Pathogens”

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PubMed1995

Compliance with universal precautions among health care workers at three regional hospitals.

OBJECTIVE: To assess and characterize self-reported levels of compliance with universal precautions among hospital-based health care workers and to determine correlates of compliance. DESIGN: Confidential questionnaire survey of 1716 hospital-based health care workers. PARTICIPANTS: Participants were recruited from three geographically distinct hospitals. A stratified convenience sample of physicians, nurses, technicians, and phlebotomists working in emergency, surgery, critical care, and laboratory departments was selected from employment lists to receive the survey instrument. All participants had direct contact with either patients or patient specimens. RESULTS: For this study, overall compliance was defined as "always" or "often" adhering to the desired protective behavior. Eleven different items composed the overall compliance scale. Compliance rates varied among the 11 items, from extremely high for certain activities (e.g., glove use, 97%; disposal of sharps, 95%) to low for others (e.g., wearing protective outer clothing, 62%; wearing eye protection, 63%). Compliance was strongly correlated with several key factors: (1) perceived organizational commitment to safety, (2) perceived conflict of interest between workers' need to protect themselves and their need to provide medical care to patients; (3) risk-taking personality; (4) perception of risk; (5) knowledge regarding routes of HIV transmission; and (6) training in universal precautions. Compliance rates were associated with some demographic characteristics: female workers had higher overall compliance scores than did male workers (25% of female and 19% of male respondents circled "always" or "often" on each of the 11 items, p < 0.05); and overall compliance scores were highest for nurses, intermediate for technicians, and lowest for physicians. Overall compliance scores were higher for the mid-Atlantic respondents (28%) than for those from the Southwest (20%) or Midwest (20%, p = 0.001). CONCLUSIONS: This study supports earlier findings regarding several compliance correlates (perception of risk, knowledge of universal precautions), but it also identifies important new variables, such as the organizational safety climate and perceived conflict of interest. Several modifiable variables were identified, and intervention programs that address as many of these factors as possible will probably succeed in facilitating employee compliance.

Blood-Borne Pathogens↗
PubMed1995

Postexposure prophylaxis for occupational exposures to hepatitis B, hepatitis C, and human immunodeficiency virus.

Bloodborne pathogens are becoming increasingly prevalent in, and therefore contributing increasing levels of risk to, the health-care work-place environment. This problem is magnified in the blood-intense operating room and obstetric environments. Whereas we will never be able to eliminate such risks entirely from the health-care workplace, a multifaceted approach to the management of these risks throughout the hospital environment and particularly in risk-intense environments will likely create a safer milieu and climate. Such an improved environment will clearly be necessary as we continue to strive to provide optimal care for all patients, irrespective of their bloodborne infection status.

Blood-Borne Pathogens↗
PubMed1995

Preventing bloodborne pathogen transmission from health-care workers to patients. The CDC perspective.

The development of recommendations to manage the risk of bloodborne pathogen transmission from health-care workers to patients during invasive procedures has been difficult, primarily because of the limitations of available scientific data. Ultimately, both health-care workers and patients will be protected best by compliance with infection control precautions and by development of new instruments, protective equipment, and techniques that reduce the likelihood of intraoperative blood exposure without adversely affecting patient care.

Blood-Borne Pathogens↗
PubMed1995

Survival and infectivity of Babesia in blood maintained at 25 C and 2-4 C.

Babesia microti-infected blood was stored at room temperature (approximately 25 C) or refrigerated (4 C) for 30 days. To assess viability of the parasites after storage at these 2 temperatures, a 0.25-ml aliquot was inoculated into each of 2 hamsters in 2 separate experiments at days 3, 7, 10, 14, 17, 21, 25, and 30. Blood films were prepared and examined weekly for the presence of parasites from all hamsters. Of hamsters inoculated with blood held at room temperature, only those inoculated at day 3 became positive, whereas 4/4 hamsters inoculated with refrigerated blood on day 17 became parasitemic and 1/4 hamsters inoculated with blood held for 21 days became parasitemic. These results indicate that under blood banking conditions, this intracellular protozoan parasite can remain infective and transfusion-acquired infection with this parasite could occur throughout most of the time that blood is normally stored.

Animals↗
PubMed1995

[Batch documentation of blood products].

BACKGROUND: In former years transmission of infectious diseases by blood products was repeatedly observed. To trace these incriminated batches of blood products proved to be nearly impossible. METHODS: This publication describes the documentation of different batches of blood products. In the simpliest case the batch numbers of blood products can be stored in files using forms. Besides this documentation of batches can be aided by EDP using databases and barcodes. A test for the correct and complete input of data is given. RESULTS: The registration of batches of commercially available blood products as well as blood preserves is possible. Incriminated batches can be traced back. CONCLUSIONS: Besides donor selection, control of the manufacturing process and the use of inactivation procedures for viruses the documentation of batches substantially contributes to the safety of plasma derivatives. With the applied techniques documentation is easily achieved.

Blood Component Transfusion↗
PubMed1993

The dentist, HIV and the law: duty to treat, need to understand.

An understanding of three areas of law--anti-discrimination, workplace safety and privacy and confidentiality--is helpful to dentists in meeting their responsibilities to treat HIV-infected individuals. This understanding also will assist in establishing a practice atmosphere in which HIV-infected patients will feel comfortable enough to fully disclose their condition and discuss treatment options with the care provider.

Blood-Borne Pathogens↗
PubMedDate not supplied

Immunological characterization of pulmonary intravascular macrophages.

Pulmonary intravascular macrophages (PIMs) are lung macrophages found apposed to the endothelium of pulmonary capillaries. In many species, they are responsible for the clearance of blood-borne particulates and pathogens; however, little else is known about their roles as immunologic effector cells. We compared PIMs with pulmonary alveolar macrophages (PAMs) to determine the relative immunological activities of these two cell populations. Our results suggested that both populations possess similar phagocytic and bactericidal activities. In assays measuring cytotoxicity, PIMs were more cytotoxic than PAMs against virally infected target cells; however, differences between these macrophage populations were not as marked when noninfected targets were used. LPS-stimulated PIMs produced more T-cell proliferative cytokines than PAMs, and both populations of nonstimulated macrophages produced similar amounts of the cytokines. In contrast, PAMs produced more TNF alpha and NO2- than PIMs when both populations were stimulated with LPS; however, nonstimulated PAMs and PIMs produced similar amounts of TNF alpha and NO2. These data suggest that bovine PIMs are immunologically active. Differences between the degrees of activity of PIMs and PAMs indicate that these macrophage populations may have different roles in lung surveillance.

Animals↗
PubMed1991

[Acute hematogenous osteomyelitis due to ordinary germs in children with closed injuries. Study of a series of 44 cases].

The retrospective study of a series of 44 cases of acute hematogenous osteomyelitis in infants and children has shown that 16 out of the 44 patients (36%) have a history of previous trauma at the site of bone infection. Seven infants were less than one year of age. For the remaining 37 children the incidence of previous local trauma rose to 43% (16/37). This incidence is similar to that in previous studies. Acute hematogenous osteomyelitis follows blood-borne spread of a pathogen from a portal of entry. Why hematogenous infection selects a particular bone is an enigma. Trauma has been said to predispose to the localization of infection but the association between trauma and hematogenous osteomyelitis is only found in one-third of the cases in both this study and in previous series. However these cases with a history of local trauma raise questions regarding the concept of "locus minoris resistentiae" and its medicolegal consequences.

Acute Disease↗
PubMed1992

Neisserial surface variation: how and why?

Neisseria gonorrhoeae exhibits striking variability in several of its surface components (pili, Opa proteins and lipooligosaccharide) in vivo and in vitro. Such flagrant variation of this mucosal pathogen's surface components contrasts sharply with changes in single surface components of blood-borne trypanosomes and borreliae. Despite these differences, similar molecular events are sometimes involved.

Animals↗
PubMed1991

[Therapy and prognosis of bacterial arthritis: a retrospective analysis].

Antibiotic therapy and immediate drainage of the infected joint are established practice in the treatment of septic arthritis. The best method of drainage (repeated puncture, arthroscopy or surgical discharge) remains controversial. We analyze 34 patients with septic arthritis admitted to our hospital from 1984 to 1988. The pathogen was Staphylococcus aureus in 19 cases (56%), streptococcus in 6 (18%), pneumococcus in 2 (6%), other bacteria in (9%) and unknown in 4 (12%). In 62% the infection was blood-borne. The knee was affected in 12 cases (35%) and the shoulder in 10 (30%). A preceding joint puncture was the main source of infection. In 24 patients (70%) the initial joint drainage was by repeated puncture, while in 10 cases (30%) surgical drainage was the initial treatment. In 11 of the 24 patients initially treated by repeated puncture, surgical drainage was needed in the course of treatment because of persistent local infection of the joint. In only 13 (39%) was "medical" treatment alone effective. 5 patients died (14.7), 3 (8.8%) due to the infection. All deaths occurred in the "medical" group. 21 patients were asked about symptoms in the affected joint. In 71% there were no problems or only minimal ones, while in 29% there were distinct problems. 5 of the 6 patients with severe symptoms had been treated by repeated puncture. We conclude that surgical drainage of an infected joint is prescribed too rarely in departments of rheumatology and internal medicine. Arthroscopic or surgical drainage is indicated in cases of coxarthritis, omarthritis, in cases where symptoms last longer than 7 days and in patients with severe sepsis.

Adult↗
PubMed1991

Epidemiology and pathogenicity of human retroviruses.

The human retroviruses can be divided into oncovirus (HTLV-I and HTLV-II) and lentivirus strains (HIV-1 and -2). The HTLVs are endemic in Central Africa, the Caribbean Islands and in southwest Japan, but now tend to spread through the i.v.-drug user population in the USA and in some countries in Western Europe. HTLV infection is associated with a malignant form of adult T-cell leukemia, tropical spastic paraparesis (TSP) and an associated myelopathy (HAM). The pathogenic mechanisms of HTLV are as yet poorly understood. HIV infection is spreading rapidly almost world-wide and has reached epidemic proportions in Central Africa, parts of South America and in certain populations in industrialized countries that have risk behaviour for contracting venereal or blood-borne infections. The mechanisms of HIV-induced immune suppression are still not entirely clear, as direct T-lymphocyte destruction after viral infection cannot account for the almost complete loss of CD4 T-cells in the final stages of disease. Various indirect mechanisms of HIV-induced immune cell destruction are outlined below.

Biological Products↗
PubMedDate not supplied

Epididymitis, orchitis, and related conditions.

Epididymitis is the most common intrascrotal inflammation. Retrograde ascent of pathogens is the usual route of infection. Nonspecific bacterial epididymitis is caused by various aerobic bacteria, is frequently associated with anatomic abnormalities, and represents the most common type of epididymitis in older men. Sexually transmitted epididymitis is usually caused by Chlamydia trachomatis or Neisseria gonorrhoeae and represents the most frequent cause of acute scrotal swelling in men younger than 35 years of age. Underlying urologic abnormalities are uncommon in patients with sexually transmitted epididymitis. Systemic infections and trauma are unusual causes of epididymitis. Orchitis is less common than epididymitis. Blood-borne dissemination is the major route of testicular infection. With the exception of viral diseases, genitourinary tract infections seldom involve the testis primarily. Mumps is the most frequent cause of viral orchitis. Pyogenic orchitis usually results from an inflammatory process in the epididymis. Systemic dissemination of granulomatous infections may occasionally cause orchitis.

Adult↗
PubMed1984

Observations on blood-borne parasites of domestic livestock in the lower Juba region of Somalia.

The commonest parasite to be found in blood of cattle in the Lower Juba Region is Theileria mutans. Antibodies against Trypanosoma spp. and Anaplasma marginale could be detected serologically whereas no antibodies against T. parva and T. annulata were present. A list of ticks collected between 1980 and 1982 in the above mentioned area shows that vectors of T. mutans are common. As the cattle throughout the region are indigenous Somali Boran it seems that endemic stability is maintained and mortality from T. mutans infection is negligible. It is not yet clear whether pathogenic strains of T. mutans similar to those isolated in East Africa occur.

Animals↗
PubMed1988

Occurrence of interleukin-1 in cerebrospinal fluid of the conscious cat.

Interleukin-1 (IL-1) is synthesized and released in response to various pathogens, including bacterial endotoxin, and is assigned an intermediary function in the genesis of fever. Its site of action in the central nervous system (CNS), however, is uncertain because the polypeptide is seemingly unable to cross the blood-brain barrier. Since several cell types, including astroglial, microglial, and vascular cells, can generate IL-1 upon appropriate stimulation, we examined whether IL-1 is formed in the CNS and may therefore serve as a messenger for systemic noxae. Experiments were conducted in the conscious cat and IL-1 was assayed in cerebrospinal fluid (CSF) from the third ventricle using a highly sensitive murine helper T cell line, D10.G4.1. In general, IL-1 levels were barely detectable in the absence of fever and did not increase at any stage of the sustained fever following intravenous injection of endotoxin (bolus) or crude monocyte supernate containing IL-1 (bolus plus infusion). In contrast, intracerebroventricular injection of a pyrogenic dose of endotoxin led to the appearance of IL-1 in the CSF. IL-1 levels reached maximal elevation during the uprise phase of the fever and declined thereafter. By the same route, natural or recombinant human IL-1 had no effect on CSF-IL-1 levels, though both preparations were as effective as endotoxin in eliciting fever. These findings confirm earlier data with radiolabelled pyrogens and indicate that the blood-brain barrier is impermeable to IL-1. We conclude that blood-borne IL-1 is likely to act at a discrete site outside the blood-brain barrier, possibly the organum vasculosum laminae terminalis. Centrally formed IL-1 may instead act diffusely in promoting fever and fever-related events (e.g. sleep).

Animals↗