title: Improving water quality can reduce pyrogenic reactions associated with reuse of cardiac catheters.
abstract: OBJECTIVE
  To report the results of our preintervention investigation and subsequent 19-month three-phase intervention study designed to reduce pyrogenic reactions among patients undergoing cardiac catheterization using reprocessed catheters.
  
  
  METHODS
  A case-control study for the preintervention period and a prospective cohort study for the intervention period.
  
  
  METHODS
  A 400-bed hospital in Belo Horizonte, Brazil.
  
  
  METHODS
  Any patient undergoing cardiac catheterization in the hospital.
  
  
  METHODS
  Three intervention phases were implemented to improve the quality of the water supplied to the cardiac catheter reprocessing laboratory. Standard operating procedures for reprocessing cardiac catheters were established and reprocessing staff were trained and educated.
  
  
  RESULTS
  The rate of pyrogenic reactions decreased significantly during the intervention phases, from 12.8% (159 of 1,239) in phase 1 to 5.3% (38 of 712) in phase 2 to 0.5% (4 of 769) in phase 3 (chi-square test for linear trend, 97.5; P < .001).
  
  
  CONCLUSIONS
  Improving water quality and using standard operating procedures for reprocessing catheters can prevent pyrogenic reactions in hospitalized patients.
authors.affiliation: Division of Healthcare Quality Promotion, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
authors.forename: Rosemary E
authors.initials: RE
authors.lastname: Duffy
authors.forename: Braulio
authors.initials: B
authors.lastname: Couto
authors.forename: Jussara M
authors.initials: JM
authors.lastname: Pessoa
authors.forename: Carlos
authors.initials: C
authors.lastname: Starling
authors.forename: Silma
authors.initials: S
authors.lastname: Pinheiro
authors.forename: Michele L
authors.initials: ML
authors.lastname: Pearson
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Arduino
authors.forename: Barbara J
authors.initials: BJ
authors.lastname: Mattson
authors.forename: William R
authors.initials: WR
authors.lastname: Jarvis
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil; D006328:Cardiac Catheterization / Q000009:adverse effects* / Q000295:instrumentation; D016022:Case-Control Studies; D002404:Catheterization / Q000009:adverse effects / Q000592:standards; D003428:Cross Infection / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D003666:Decontamination / Q000379:methods*; D004866:Equipment Contamination; D017743:Equipment Reuse; D006801:Humans; D017053:Infection Control / Q000379:methods*; D008875:Middle Aged; D011446:Prospective Studies; D011749:Pyrogens / Q000097:blood; D018805:Sepsis / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D014871:Water Microbiology; D018508:Water Purification
chemical_list: D011749:Pyrogens