Febrile respiratory illness in the intensive care unit setting: An infection control perspective

Current Opinion in Critical Care

Volumn 12, Issue 1, 2006, Pages 37-42

  Muller, Matthew P ^a   McGeer, Allison ^a  

^a UNIVERSITY OF TORONTO   (Canada)

Author keywords

Infection prevention and control; Intensive care unit; Respiratory tract infection; Severe acute respiratory syndrome

Indexed keywords

AEROSOL; CANADA; DISEASE TRANSMISSION; EPIDEMIC; FEVER; HAND WASHING; HEALTH CARE PERSONNEL; HUMAN; IMMUNIZATION; INFECTION CONTROL; INFLUENZA; INTENSIVE CARE UNIT; MEASLES VIRUS; MORBIDITY; MORTALITY; MYCOBACTERIUM TUBERCULOSIS; NURSE PATIENT RATIO; PROTECTIVE EQUIPMENT; RESPIRATORY TRACT INFECTION; REVIEW; SEVERE ACUTE RESPIRATORY SYNDROME; SMALLPOX VIRUS; STREPTOCOCCUS GROUP A; SURGICAL MASK; VARICELLA ZOSTER VIRUS; VENTILATOR ASSOCIATED PNEUMONIA;

EID: 33646092083     PISSN: 10705295     EISSN: 15317072     Source Type: Journal    
DOI: 10.1097/01.ccx.0000198056.58083.a1     Document Type: Review

References (59)

1. Harrison DA, Brady AR, Rowan K. Case mix, outcome and length of stay for admissions to adult, general critical care units in England, Wales and Northern Ireland: the Intensive Care National Audit and Research Centre Case Mix Programme Database. Crit Care 2004; 8:R99-R111. This is a large study of over 100 000 ICU admissions in the UK that provides demographic, epidemiological and clinical information including data on the most common reasons for ICU admission.
2. Peiris JS, Chu CM, Cheng VC, et al. Clinical progression and viral load in a community outbreak of coronavirus-associated SARS pneumonia: a prospective study. Lancet 2003; 361:1767-1772.
3. Fowler RA, Guest CB, Lapinsky SE, et al. Transmission of severe acute respiratory syndrome during intubation and mechanical ventilation. Am J Respir Crit Care Med 2004; 169:1198-1202. This study examines the transmission of SARS during high-risk procedures in the ICU and identifies endotracheal intubation as a risk factor for SARS acquisition.
4. Scales DC, Green K, Chan AK, et al. Illness in intensive care staff after brief exposure to severe acute respiratory syndrome. Emerg Infect Dis 2003; 9:1205-1210.
5. Ofner M, Lem M, Sarwal S, et al. Cluster of severe acute respiratory syndrome cases among protected health care workers - Toronto, April 2003. Can Commun Dis Rep 2003; 29:93-97.
6. Christian MD, Loutfy M, McDonald LC, et al. Possible SARS coronavirus transmission during cardiopulmonary resuscitation. Emerg Infect Dis 2004; 10:287-293. This study describes SARS transmission occurring after the performance of cardiopulmonary resuscitation on a SARS patient and discusses possible strategies to minimize transmission related to high-risk procedures.
7. Eggimann P, Pittet D. Infection control in the ICU. Chest 2001; 120:2059-2093.
8. Tablan OC, Anderson LJ, Besser R, et al. Guidelines for preventing health-care-associated pneumonia, 2003: recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee. MMWR Recomm Rep 2004; 53 (RR-3):1-36. These recent guidelines make recommendations for the prevention of hospital-acquired pneumonia for all common pathogens, and summarize the evidence supporting their recommendations.
9. Bartlett JG, Dowell SF, Mandell LA, et al. Practice guidelines for the management of community-acquired pneumonia in adults. Infectious Diseases Society of America. Clin Infect Dis 2000; 31:347-382.
10. Booth CM, Matukas LM, Tomlinson GA, et al. Clinical features and short-term outcomes of 144 patients with SARS in the greater Toronto area. JAMA 2003; 289:2801-2809.
11. Lee N, Hui D, Wu A, et al. A major outbreak of severe acute respiratory syndrome in Hong Kong. N Engl J Med 2003; 348:1986-1994.
12. Yu IT, Li Y, Wong TW, et al. Evidence of airborne transmission of the severe acute respiratory syndrome virus. N Engl J Med 2004; 350:1731-1739. This study of the Amoy Gardens SARS outbreak strongly suggested that SARS was transmitted by the airborne route during this unusual outbreak.
13. Varia M, Wilson S, Sarwal S, et al. Investigation of a nosocomial outbreak of severe acute respiratory syndrome (SARS) in Toronto. Canada Can Med Assoc J 2003; 169:285-292.
14. Yu IT, Wong TW, Chiu YL, et al. Temporal-spatial analysis of severe acute respiratory syndrome among hospital inpatients. Clin Infect Dis 2005; 40:1237-1243. This study of a large nosocomial SARS outbreak resulting from a single index patient suggested that airborne transmission was the cause of the majority of first-generation cases.
15. Gamage B, Moore D, Copes R, et al. Protecting health care workers from SARS and other respiratory pathogens: a review of the infection control literature. Am J Infect Control 2005; 33:114-121. This review examines and draws conclusions from a number of primary studies on transmission and the efficacy of PPE during the SARS outbreak.
16. Roy CJ, Milton DK. Airborne transmission of communicable infection - the elusive pathway. N Engl J Med 2004; 350:1710-1712. This editorial describes our evolving understanding of airborne transmission and defines obligate, preferential and opportunistic airborne transmission.
17. Moser MR, Bender TR, Margolis HS, et al. An outbreak of influenza aboard a commercial airliner. Am J Epidemiol 1979; 110:1-6.
18. Schulman JL, Kilbourne ED. Airborne transmission of influenza virus infection in mice. Nature 1962; 195:1129-1130.
19. Goldmann DA. Transmission of viral respiratory infections in the home. Pediatr Infect Dis J 2000; 19 (10 Suppl.):S97-S102.
20. Lidwell OM. Aerial dispersal of micro-organisms from the human respiratory tract. Soc Appl Bacteriol Symp Ser 1974; 3:135-154.
21. Bridges CB, Kuehnert MJ, Hall CB. Transmission of influenza: implications for control in health care settings. Clin Infect Dis 2003; 37:1094-1101.
22. Meadows E, Le Saux N. A systematic review of the effectiveness of antimicrobial rinse-free hand sanitizers for prevention of illness-related absenteeism in elementary school children. BMC Public Health 2004; 4:1-11. This systematic review examines the ability of hand disinfection to reduce respiratory infection. Although the studies included were of low quality, hand disinfection was consistently effective in all five published studies examined.
23. White C, Kolble R, Carlson R, et al. The effect of hand hygiene on illness rate among students in university residence halls. Am J Infect Control 2003; 31:364-370.
24. Ryan M, Christian R, Wohlrabe J. Handwashing and respiratory illness among young adults in military training. Am J Prevent Med 2001; 21:79-83.
25. Seto WH, Tsang D, Yung RW, et al. Effectiveness of precautions against droplets and contact in prevention of nosocomial transmission of severe acute respiratory syndrome (SARS). Lancet 2003; 361:1519-1520.
26. Teleman MD, Boudville IC, Heng BH, et al. Factors associated with transmission of severe acute respiratory syndrome among health-care workers in Singapore. Epidemiol Infect 2004; 132:797-803. This study of SARS transmission in Singapore identified hand washing as a protective strategy, and direct contact with respiratory secretions as a risk factor for SARS acquisition among HCWs, and provides strong evidence that contact transmission is important in SARS.
27. Lau JT, Tsui H, Lau M, Yang X. SARS transmission, risk factors, and prevention in Hong Kong. Emerg Infect Dis 2004; 10:587-592. This study examines risk factors associated with the transmission of SARS in the community in Hong Kong.
28. Beigel JH, Farrar J, Han AM, et al. Avian influenza A (H5N1) infection in humans. N Engl J Med 2005; 353:1374-1385. This review article on avian influenza summarizes current infection control recommendations for dealing with suspected avian influenza in humans.
29. Centers for Disease Control and Prevention. Public health guidance for community-level preparedness and response to severe acute respiratory syndrome (SARS), 2005. Available at: www.cdc.gov/nicdod/sars/ guidance/index.htm. Accessed: 1 October 2005. These are Centers for Disease Control and Prevention guidelines describing the recommended infection control precautions required when caring for suspected SARS patients.
30. World Health Organization. Hospital infection control guidance for severe acute respiratory syndrome (SARS), 2003. Available at: www.who.int/csr/ sars/infectioncontrol/en/. Accessed: 1 October 2005. These are World Health Organization guidelines describing the recommended infection control precautions required when caring for suspected SARS patients.
31. Carman W, Elder A, Wallace L, et al. Effects of influenza vaccination of health-care workers on mortality of elderly people in long-term care: a randomised controlled trial. Lancet 2000; 355:93-97.
32. Potter J, Stott D, Roberts M, et al. Influenza vaccination of health care workers in long-term-care hospitals reduces the mortality of elderly patients. J Infect Dis 1997; 175:1-6.
33. Canadian Government. Preventing febrile respiratory illnesses. 2005. Available at: www.health.gov.on.ca/english/providers/program/infectious/ diseases/best_ prac/bp_fri. Accessed: 1 October 2005. These are guidelines from Ontario, Canada that describe current Canadian recommendations regarding infection control precautions for patients with febrile respiratory illness.
34. The role of the physical environment in the hospital of the 21st century: a once-in-a-lifetime opportunity. Report to the Centre for Health Design for the Designing the 21st Century Hospital Project. September, 2004. Available at: http://www.rwjf.org/files/publications/other/RoleofthePhysicalEnvironment. pdf. Accessed: 2005. This document summarizes the advantages and disadvantages of single occupancy rooms in the ICU.
35. Shirani KZ, McManus AT, Vaughan GM, et al. Effects of environment on infection in burn patients. Arch Surg 1986; 121:31-36.
36. Muto CA, Jernigan JA, Ostrowsky BE, et al. SHEA guideline for preventing nosocomial transmission of multidrug-resistant strains of Staphylococcus aureus and enterococcus. Infect Control Hosp Epidemiol 2003; 24:362-386.
37. Kappstein I, Daschner FD. Potential inroads to reducing hospital-acquired staphylococcal infection and its cost. J Hosp Infect 1991; 19 (Suppl. B):31-34.
38. Chaudhury H, Mahmood A, Valente M., The use of single patient rooms versus multiple occupancy rooms in acute care environments: a review and analysis of the literature. Vancouver, BC, Canada: Simon Fraser University; 30 November 2003.
39. Garner JS. Guideline for isolation precautions in hospitals. The Hospital Infection Control Practices Advisory Committee. Infect Control Hosp Epidemiol 1996; 17:53-80.
40. Routine practices and additional precautions for preventing the transmission of infection in health care. Can Commun Dis Rep 1999; 25 (Suppl. 4):1-142.
41. Lau JT, Fung KS, Wong TW, et al. SARS transmission among hospital workers in Hong Kong. Emerg Infect Dis 2004; 10:280-286. This study examines risk factors for nosocomial SARS transmission in Hong Kong and identifies the importance of adequate infection control training and the importance of having PPE available.
42. Loeb M, McGeer A, Henry B, et al. SARS among critical care nurses. Toronto Emerg Infect Dis 2004; 10:251-255. This study examines the transmission of SARS among critical care nurses in a Toronto outbreak, compares the efficacy of N95 and surgical masks, and confirms that intubation is a risk factor for SARS acquisition.
43. Pittet D, Mourouga P, Perneger TV. Compliance with handwashing in a teaching hospital. Infection Control Program. Ann Intern Med 1999; 130:126-130.
44. Boyce JM, Pittet D. Guideline for hand hygiene in health-care settings. Recommendations of the Healthcare Infection Control Practices Advisory Committee and the HIPAC/SHEA/APIC/IDSA Hand Hygiene Task Force. Am J Infect Control 2002; 30:S1-S46.
45. Kelen GD, DiGiovanna TA, Celentano DD, et al. Adherence to universal (barrier) precautions during interventions on critically ill and injured emergency department patients. J Acquir Immune Defic Syndr 1990; 3:987-994.
46. Tokars JI, McKinley GF, Otten J, et al. Use and efficacy of tuberculosis infection control practices at hospitals with previous outbreaks of multidrug-resistant tuberculosis. Infect Control Hosp Epidemiol 2001; 22:449-455.
47. Hugonnet S, Perneger TV, Pittet D. Alcohol-based handrub improves compliance with hand hygiene in intensive care units. Arch Intern Med 2002; 162:1037-1043.
48. Fridkin SK, Pear SM, Williamson TH, et al. The role of understating in central venous catheter-associated bloodstream infections. Infect Control Hosp Epidemiol 1996; 17:150-158.
49. Robert J, Fridkin SK, Blumberg HM, et al. The influence of the composition of the nursing staff on primary bloodstream infection rates in a surgical intensive care unit. Infect Control Hosp Epidemiol 2000; 21:12-17.
50. Arnow P, Allyn PA, Nichols EM, et al. Control of methicillin-resistant Staphylococcus aureus in a burn unit: role of nurse staffing. J Trauma 1982; 22:954-959.
51. Pittet D, Hugonnet S, Harbarth S, et al. Effectiveness of a hospital-wide programme to improve compliance with hand hygiene. Infection Control Programme. Lancet 2000; 356:1307-1312.
52. Moore D, Gamage B, Bryce E, et al. Protecting health care workers from SARS and other respiratory pathogens: organizational and individual factors that affect adherence to infection control guidelines. Am J Infect Control 2005; 33:88-96. This review examines organizational factors that impact on adherence to infection control guidelines in the era of SARS.
53. Le DH, Bloom SA, Nguyen QH, et al. Lack of SARS transmission among public hospital workers, Vietnam. Emerg Infect Dis 2004; 10:265-268. This study demonstrated that SARS can be controlled with the use of standard/ droplet precautions alone, as N95 masks were not available during the first 3 weeks of this outbreak, but nosocomial transmission did not occur.
54. Kelly L, Clark K. The effectiveness of training and taste testing when using respirator masks. J Hosp Infect 2004; 58:240-241. This small study shows that without training, N95 masks are not used properly by HCWs.
55. Huff RD, Horwitz P, Klash SJ. Personnel protection during aerosol ventilation studies using radioactive technetium (Tc99m). Am Ind Hyg Assoc J 1994; 55:1144-1148.
56. Hannan MM, Peres H, Maltez F, et al. Investigation and control of a large outbreak of multi-drug resistant tuberculosis at a central Lisbon hospital. J Hosp Infect 2001; 47:91-97.
57. Nelson H. USA: objections to protective respirators. Lancet 1992; 340:1088.
58. Khoo KL, Leng PH, Ibrahim IB, Lim TK. The changing face of healthcare worker perceptions on powered air-purifying respirators during the SARS outbreak. Respirology 2005; 10:107-110. This study examines HCW acceptance of PAPRs for SARS.
59. Hugonnet S, Pittet D. Transmission of severe acute respiratory syndrome in critical care: do we need a change? [Comment] Am J Respir Crit Care Med 2004; 169:1177-1178. This editorial considers evidence on the transmission of SARS within ICUs and the association with aerosol-generating procedures and concludes that adherence to simple, established measures such as hand disinfection offers the best protection again SARS transmission within the ICU.