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.
Interdepartmental Division of Critical Care Medicine, University of Toronto, Sunnybrook and Women's College Health Sciences Centre, Toronto, Ontario, Canada. rob.fowler@sw.ca
Robert A
RA
Fowler
Cameron B
CB
Guest
Stephen E
SE
Lapinsky
William J
WJ
Sibbald
Marie
M
Louie
Patrick
P
Tang
Andrew E
AE
Simor
Thomas E
TE
Stewart
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