Hospital Airborne Infection Control PDF
Preview Hospital Airborne Infection Control
K11161_cover 11/1/11 11:13 AM Page 1 C M Y CM MY CY CMY K ENVIRONMENTAL ENGINEERING K O W A HOSPITAL L S K I AIRBORNE INFECTION H O CONTROL S P I T Although nosocomial, or hospital-acquired, infections have been well cataloged and A are fairly well understood, traditional solutions have failed to completely eliminate the L problem. Even the most modern hospitals find themselves stymied by the persistence A of these pathogens in hospital wards and operating rooms. The degree to which most I of these infections are airborne is not known, but a growing body of evidence indicates R that airborne transmission plays a role in many hospital-acquired infections. B O Addressing one of the most important topics in health care, Hospital Airborne Infection R Control is the first book to deal with the control of airborne nosocomial infections in N detail. It identifies all pathogens known or suspected to be airborne, along with their E sources in hospital environments. It also summarizes all epidemiological evidence for I N airborne transmission. The text addresses respiratory, surgical site, burn wound, immunocompromised, pediatric, nursing home, and non-respiratory infections. In each F E category, an extensive number of examples show that inhalation is not the only airborne C route by which infections may be transmitted. T I Noting that airborne transmission and surface contamination are virtually inseparable, O the author emphasizes that both air and surface disinfection, including hand hygiene, N are important factors in controlling the transmission of airborne disease. He also proposes C a variety of new solutions and technologies, including ultraviolet, ionization, ozone, O plasma, and vegetative air cleaning systems. A compendium of scientific and medical information, this book helps hospitals control nosocomial infections and outbreaks N spread by the airborne route as well as by direct contact and contact with fomites or T contaminated equipment. R O L K11161 WLADYSLAW KOWALSKI 6000 Broken Sound Parkway, NW Suite 300, Boca Raton, FL 33487 711 Third Avenue an informa business New York, NY 10017 www.crcpress.com 2 Park Square, Milton Park www.crcpress.com Abingdon, Oxon OX14 4RN, UK Composite HOSPITAL AIRBORNE INFECTION CONTROL HOSPITAL AIRBORNE INFECTION CONTROL WLADYSLAW KOWALSKI Boca Raton London New York CRC Press is an imprint of the Taylor & Francis Group, an informa business CRC Press Taylor & Francis Group 6000 Broken Sound Parkway NW, Suite 300 Boca Raton, FL 33487-2742 © 2012 by Taylor & Francis Group, LLC CRC Press is an imprint of Taylor & Francis Group, an Informa business No claim to original U.S. Government works Version Date: 20111020 International Standard Book Number-13: 978-1-4398-2200-5 (eBook - PDF) This book contains information obtained from authentic and highly regarded sources. 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I hope this book makes a small contribution to their understanding of this complex problem. Contents Preface......................................................................................................................xv Acknowledgments..............................................................................................xvii The.Author............................................................................................................xix 1. Airborne Nosocomial Infections..................................................................1 Introduction.......................................................................................................1 Nosocomial.Infection.Epidemiology.............................................................2 Airborne.Nosocomial.Pathogens...................................................................7 Airborne.Infection.Categories........................................................................8 Infection.Control.Precautions.......................................................................10 Infections.in.Health.Care.Workers...............................................................11 Multidrug.Resistance.....................................................................................12 Toward.Airborne.Infection.Control.............................................................13 References........................................................................................................14 2. Airborne Nosocomial Epidemiology.........................................................17 Introduction.....................................................................................................17 Airborne.Transmission.Routes.....................................................................18 Epidemiological.Principles............................................................................19 Dosimetry.of.Airborne.Disease....................................................................22 Survival.of.Microbes.Outside.the.Host.......................................................26 Settling.of.Microbes.in.Air............................................................................28 References........................................................................................................30 3. Hospital Aerobiology....................................................................................33 Introduction.....................................................................................................33 Airborne.Levels.of.Bacteria...........................................................................34 Airborne.Levels.of.Fungal.Spores................................................................36 Airborne.Virus.Levels....................................................................................37 References........................................................................................................38 4. Airborne Nosocomial Microorganisms....................................................41 Introduction.....................................................................................................41 Airborne.Nosocomial.Pathogens.................................................................41 Airborne.Nosocomial.Bacteria.....................................................................46 Airborne.Nosocomial.Viruses......................................................................47 Airborne.Nosocomial.Fungi.........................................................................48 Database.of.Airborne.Nosocomial.Pathogens............................................49 Acinetobacter:.Noncontagious.Bacteria—Airborne.Class.2...................49 Adenovirus:.Communicable.Virus—Airborne.Class.2........................49 vii viii Contents Alcaligenes:.Noncontagious.Bacteria—Airborne.Class.2......................50 Alternaria alternata:.Noncontagious.Fungal.Spore— Airborne.Class.2.........................................................................................50 Aspergillus:.Noncontagious.Fungal.Spore—Airborne.Class.1.............51 Blastomyces dermatitidis:.Noncontagious.Fungal.Spore— Airborne.Class.2.........................................................................................51 Bordetella pertussis:.Communicable.Bacteria—Airborne.Class.1.........51 Clostridium difficile:.Noncontagious.Bacterial.Spore— Airborne.Class.1.........................................................................................52 Clostridium perfringens:.Noncontagious.Bacterial.Spore— Airborne.Class.2.........................................................................................53 Coccidioides immitis:.Noncontagious.Fungal.Spore— Airborne.Class.2.........................................................................................53 Coronavirus:.Communicable.Virus—Airborne.Class.1.......................53 Corynebacterium diphtheriae:.Contagious.Bacteria—. Airborne.Class.2.....................................................................................54 Coxsackievirus:.Communicable.Virus—Airborne.Class.2..................54 Cryptococcus neoformans:.Noncontagious.Fungal.Yeast— Airborne.Class.2.........................................................................................55 Enterobacter cloacae:.Noncontagious.Bacteria—Airborne.Class.2........55 Enterococcus.(VRE):.Communicable.Bacteria—Airborne.Class.2........55 Fugomyces cyanescens:.Noncontagious.Fungal.Spore— Airborne.Class.2.........................................................................................56 Fusarium:.Noncontagious.Fungal.Spore—Airborne.Class.2................57 Haemophilus influenzae:.Communicable.Bacteria— Airborne.Class.2.....................................................................................57 Haemophilus parainfluenzae:.Communicable.Bacteria— Airborne.Class.2.........................................................................................57 Histoplasma capsulatum:.Noncontagious.Fungal.Spore— Airborne.Class.1.........................................................................................58 Influenza.A.Virus:.Contagious.Virus—Airborne.Class.1....................58 Klebsiella pneumoniae:.Communicable.Bacteria—..... Airborne.Class.2.........................................................................................59 Legionella pneumophila:.Noncontagious.Bacteria—... Airborne.Class.1.........................................................................................60 Measles.Virus:.Contagious.Virus—Airborne.Class.1...........................60 Mucor:.Noncontagious.Fungal.Spore—Airborne.Class.2....................61 Mumps.Virus:.Contagious.Virus—Airborne.Class.1...........................61 Mycobacterium avium:.Contagious.Bacteria—Airborne.Class.2...........62 Mycobacterium tuberculosis:.Contagious.Bacteria—... Airborne.Class.1.........................................................................................62 Mycoplasma pneumoniae:.Communicable.Bacteria— Airborne.Class.2.........................................................................................63 Neisseria meningitides:.Communicable.Bacteria—..... Airborne.Class.2.........................................................................................63 Contents ix Nocardia asteroides:.Noncontagious.Bacterial.Spore— Airborne.Class.2.........................................................................................64 Norwalk.Virus:.Contagious.Virus—Airborne.Class.1.........................64 Parainfluenza.Virus:.Contagious.Virus—Airborne.Class.2................64 Parvovirus.B19:.Contagious.Virus—Airborne.Class.2.........................65 Penicillium:.Noncontagious.Fungal.Spore—Airborne.Class.2.............65 Pneumocystis jirovecii:.Noncontagious.Fungal.Spore— Airborne.Class.2.........................................................................................66 Proteus mirabilis:.Noncontagious.Bacteria—Airborne.Class.2.............66 Pseudallescheria boydii:.Noncontagious.Fungal.Yeast— Airborne.Class.2.........................................................................................67 Pseudomonas aeruginosa:.Noncontagious.Bacteria—. Airborne.Class.1.......................................................................................67 Reovirus:.Contagious.Virus—Airborne.Class.2....................................68 Respiratory.Syncytial.Virus.(RSV):.Contagious.Virus— Airborne.Class.1.........................................................................................68 Rhinovirus:.Contagious.Virus—Airborne.Class.2................................69 Rhizopus:.Noncontagious.Fungal.Spore—Airborne.Class.2................69 Rotavirus:.Contagious.Virus—Airborne.Class.2..................................70 Rubella.Virus:.Contagious.Virus—Airborne.Class.1...........................70 Scedosporium:.Noncontagious.Fungal.Spore—Airborne.Class.2.........71 Serratia marcescens:.Noncontagious.Bacteria—Airborne.Class.2.........71 Staphylococcus aureus.(MRSA):.Communicable.Bacteria— Airborne.Class.1.........................................................................................72 Staphylococcus epidermis:.Communicable.Bacteria— Airborne.Class.2.........................................................................................73 Streptococcus pneumoniae:.Communicable.Bacteria— Airborne.Class.2.........................................................................................74 Streptococcus pyogenes:.Communicable.Bacteria—.... Airborne.Class.1.........................................................................................74 Trichosporon:.Noncontagious.Fungal.Yeast—Airborne.Class.2...........75 Varicella-Zoster.Virus:.Contagious.Virus—Airborne.Class.1.............75 References........................................................................................................76 5. Airborne Nosocomial Etiology...................................................................83 Introduction.....................................................................................................83 Pathogen.Aerosolization................................................................................84 Aerobiological.Pathways................................................................................86 Airborne.Transmission.of.Respiratory.Infections.....................................87 Airborne.Transport.of.Fungal.Spores..........................................................88 Shedding.of.Bacteria.......................................................................................89 Shedding.of.Clostridium difficile.Spores........................................................90 References........................................................................................................90
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