Transmission of severe acute respiratory syndrome during intubation and mechanical ventilation.
Nosocomial transmission of severe acute respiratory syndrome from critically ill patients to healthcare workers has been a prominent and worrisome feature of existing outbreaks. We have observed a greater risk of developing severe acute respiratory syndrome for physicians and nurses performing endotracheal intubation (relative risk [RR], 13.29; 95% confidence interval [CI], 2.99 to 59.04; p = 0.003). Nurses caring for patients receiving noninvasive positive-pressure ventilation may be at an increased risk (RR, 2.33; 95% CI, 0.25 to 21.76; p = 0.5), whereas nurses caring for patients receiving high-frequency oscillatory ventilation do not appear at an increased risk (RR, 0.74; 95% CI, 0.11 to 4.92; p = 0.6) compared with their respective reference cohorts. Specific infection control recommendations concerning the care of critically ill patients may help limit further nosocomial transmission.
Fowler
Robert A
RA
Interdepartmental Division of Critical Care Medicine, University of Toronto, Sunnybrook and Women's College Health Sciences Centre, Toronto, Ontario, Canada. rob.fowler@sw.ca
Guest
Cameron B
CB
Lapinsky
Stephen E
SE
Sibbald
William J
WJ
Louie
Marie
M
Tang
Patrick
P
Simor
Andrew E
AE
Stewart
Thomas E
TE
D000328:Adult; D003428:Cross Infection / Q000453:epidemiology / Q000635:transmission; D004196:Disease Outbreaks; D005260:Female; D006282:Health Personnel; D006801:Humans; D017053:Infection Control; D017758:Infectious Disease Transmission, Patient-to-Professional; D007362:Intensive Care Units; D007442:Intubation, Intratracheal / Q000009:adverse effects*; D008297:Male; D016273:Occupational Exposure / Q000009:adverse effects; D012121:Respiration, Artificial / Q000009:adverse effects*; D012307:Risk Factors; D045169:Severe Acute Respiratory Syndrome / Q000453:epidemiology / Q000635:transmission*; D013223:Statistics as Topic