The need for maximal sterile barrier precaution in routine interventional coronary procedures; microbiology analysis.
BACKGROUND
Maximal sterile barrier precautions (MSBP) including head coverings and face masks are advocated for use in invasive procedures, including coronary interventions. The rationale for MSBP assumes it is an obligatory measure for infection prevention. However, in many coronary catheterization laboratories, head coverings/face masks are not used in daily practice. This study prospectively evaluated the potential hazards of not routinely using head coverings/face masks in routine coronary interventions.


METHODS
This is a prospective study of ambulatory patients in hospital care. A total of 110 successive elective patients undergoing cardiac catheterizations were recruited. Patients were catheterized by several interventional cardiologists who employed only routine infection control precautions without head coverings or face masks. For each patient, we took blood cultures and cultures from the tips of the coronary catheters and from the sterile saline water flush bowl. Cultures were handled and analyzed at our certified hospital microbiology laboratory.


RESULTS
In none of the cultures was a clinically significant bacterial growth isolated. No signs of infection were reported later by any of the study patients and there were no relevant subsequent admissions.


CONCLUSIONS
Operating in the catheterization lab without head coverings/face masks was not associated with any bacterial infection in multiple blood and equipment cultures. Accordingly, we believe that the use of head coverings/face masks should not be an obligatory requirement and may be used at the interventional cardiologist's discretion.
Clinical Microbiology Laboratory, Baruch Padeh Medical Center, Tiberias, Israel. aperetz@poria.health.gov.il.|Faculty of Medicine in the Galilee, Bar Ilan University, Zefat, Israel. aperetz@poria.health.gov.il.
Avi
A
Peretz
Cardio-Vascular Institute, Baruch Padeh Medical Center, Poriya, Tiberias, Israel.
Fabio
F
Kuzniec
Cardio-Vascular Institute, Baruch Padeh Medical Center, Poriya, Tiberias, Israel.
Diab
D
Ganem
Cardio-Vascular Institute, Baruch Padeh Medical Center, Poriya, Tiberias, Israel.
Nabeeh
N
Salman
Faculty of Medicine in the Galilee, Bar Ilan University, Zefat, Israel.|Cardio-Vascular Institute, Baruch Padeh Medical Center, Poriya, Tiberias, Israel.
Dahud
D
Qarawani
Faculty of Medicine in the Galilee, Bar Ilan University, Zefat, Israel.|Cardio-Vascular Institute, Baruch Padeh Medical Center, Poriya, Tiberias, Israel.
Offer
O
Amir
D000368:Aged; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000295:instrumentation; D062906:Cardiac Catheters / Q000382:microbiology*; D005260:Female; D006282:Health Personnel; D006801:Humans; D017053:Infection Control / Q000379:methods* / Q000592:standards; D008297:Male; D008397:Masks; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital; D011446:Prospective Studies; D011481:Protective Clothing; D013210:Staphylococcus / Q000302:isolation & purification
Coronary catheterization laboratory; Infection transmission; Maximal sterile barrier precautions