CDC draft guidelines say no artificial nails
OR technician reported to have infected 3 patients
In the wake of a published study that an operating room technician who wore artificial nails infected three laminectomy patients with Candida albican,1 the Centers for Disease Control and Prevention (CDC) in Atlanta has drafted hand hygiene guidelines that recommend health care workers should not wear artificial nails. This will be the first time CDC has made such a recommendation for all health care workers with patient contact.
In the three cases involving infection transmitted by artificial nails at Stamford (CT) Hospital, the mean time from the surgery to diagnosis was 54 days. The OR technician had scrubbed on all three cases and had worn artificial nails during the procedures. Candida albicans was isolated from her throat; the technician was treated with fluconazole and removed from duty.
Artificial nails promote subungual growth of gram-negative bacilli and yeast, according to the published report. Previous CDC guidelines on surgical site infection "strongly recommended" no artificial nails. (For more information on surgical site infection guidelines, see Same Day Surgery, September 1999, p. 105.) Recommended Practices from the Association of periOperative Registered Nurses in Denver recommend that OR nurses not wear artificial nails. (For more information on artificial nails, see SDS, April 2000, p. 37.) Infection control experts urge SDS managers to review the literature and update their policies on artificial nails, as needed.
On another matter, the CDC is drafting a guideline on sterilization of equipment used on patients who have Creutzfeldt-Jakob disease (CJD). The guideline follows reports that instruments used on a CJD patient at Tulane University Hospital and Clinic in New Orleans were subsequently used on eight other patients. (See SDS, April 2001, p. 37.)
The CDC sterilization guideline may differ somewhat from other existing guidelines, such as that of the World Health Organization in Geneva, Switzerland. The guidelines will try to incorporate the current laboratory and epidemiological science about CJD transmission and provide the users with more flexibility, says Bill Jarvis, MD, associate director for program development in the Division of Healthcare Quality Promotion at the CDC. "All nosocomial transmission has been either brain-to-brain inoculation or injection of brain material," Jarvis says.
Reference
1. Parry MF, Grant B, Yukna M, et al. Clin Infect Dis 2001; 32:352-357.
You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
- Award-winning Medical Content
- Latest Advances & Development in Medicine
- Unbiased Content