Chatper 17 : Noninvasive Procedures

Abstract:

Millions of noninvasive procedures are being performed in hospitals and outpatient settings without harm. The colonizations or infections that result from materials that are summarized in this chapter underscore diversity rather than magnitude of exposure. Risks of cross-infection (material-to-patient spread) likely originate from reusing, handling, or storing materials rather than from producing or transporting bulk material. Transesophageal echocardiography probes were implicated in three cases of Legionella pneumonia; strains from patients and water from rinsing probes were indistinguishable by pulsed-field gel electrophoresis. Machines include respiratory ventilators, medication nebulizers, spirometers, and humidifiers. Sources of contamination include tap water, cleaning water, and hands of service or health workers. Postendoscopic infections include urinary tract infections (UTI), pneumonia, and bloodstream infection (BSI). As bronchoscopy can induce coughing and generation of aerosols, infection risks should be considered before endoscopy in carriers and incubating, ill, or recovering patients, mainly for prions, hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV), and Mycobacterium tuberculosis. Drugs are substances intended for preventive, curative, or stimulating use in humans, including illicit drugs, herbs and other alternative remedies, apothecaries, pharmaceuticals, and bioproducts. Experimental drugs are reported vehicles of viruses, bacteria, and fungi. Antimicrobials are substances used in vivo against multiplying viruses, bacteria, fungi, and protozoa, e.g., antiretrovirals, macrolides, β-lactams, tuberculostatics, and antimalarials. Person-to-person spread is confirmed for Arenaviridae, Filoviridae, and Nairovirus (Crimean-Congo hemorrhagic fever virus [CCHFV]) of Bunyaviridae.