JHPIEGO TrainerNews™ |
Infection Prevention Update: Importance
of Gloves in Infection Prevention
(March 2001)
Doctors from the Institute of Virology, National Reference Center for Hepatitis C, at the University of Essen, in Germany, reported an outbreak of hepatitis C virus (HCV) in a municipal hospital. Their findings suggest that an anesthesiology assistant contracted HCV from a chronically infected patient and subsequently transmitted the virus to five other patients during surgery. Six to 18 weeks after surgery, three of those patients exhibited acute icteric hepatitis C. The other two patients were asymptomatic after surgery.
The anesthesiology assistant who participated in all the operations was almost entirely responsible for the administration of general anesthesia, including preparation of narcotic drugs, placement of venous and arterial catheters, intubation of the patients, and the subsequent artificial respiration. He usually did not wear gloves, claiming they diminished his sense of touch and therefore impaired his work. He reported that during the time under investigation, he had a thumbnail-sized wound on the medial side of the third finger of his right hand. He used a bandage for 3 to 4 days but not thereafter, although the wound was still weeping. The assistant admitted to negligent behavior, but at the time, he considered the open wound to be an old injury and was not aware that such an attitude might be risky for him and his patients.
Numerous breaches of general infection control practices had taken place. For instance, needles were frequently recapped after use, and gloves were not always worn in settings in which exposure was likely.
The report provides evidence that a nonsurgical staff member infected with HCV transmitted the virus to at least five patients. The precise mechanism leading to infection could not be determined. The only identifiable condition that might have caused the infection was the wound on the assistant's hand.
Source: Ross RS et al. 2000. Transmission of hepatitis C virus from a patient to an anesthesiology assistant to five patients. New England Journal of Medicine 343(25):1851-1854.
For more information on infection prevention programs at JHPIEGO, contact Linda Tietjen.