Medical Center Occupational Health Basics-Handout: Guidance for Infectious Exposures- What's New

Handout: Guidance for Infectious Exposures- What's New

Pdf Summary

Dr. Mark Russi's comprehensive presentation addresses the transmission of bloodborne pathogens, focusing primarily on HIV and HCV, to healthcare workers (HCWs). It provides insights into prevention strategies, post-exposure prophylaxis (PEP), infection risks, and protocols for infected healthcare workers.<br /><br />For HIV, the background statistics reveal a low risk of seroconversion among HCWs from percutaneous (0.3%) and mucocutaneous injuries (0.03%). Preventive measures include the Needlestick Safety Act and engineered safety devices, which significantly reduce injury rates. Educational programs are crucial for awareness and prevention.<br /><br />Post-exposure, CDC guidelines advocate for immediate PEP initiation up to 72 hours after exposure with recommended antiretroviral therapies like Biktarvy or Dolutegravir regimens, taking into account resistance, drug toxicity, and new drugs like second-generation integrase inhibitors. PEP is primarily recommended for exposures with high transmission risks and should not be delayed despite waiting for source test results. The latest guidance (2023) suggests using newer antiretrovirals and follows updated recommendations aligned with non-occupational PEP.<br /><br />Regarding HCV, while no PEP is recommended, the course of potential infection includes blood testing for source patient PCR and exposed HCW Ab initially, followed by HCW PCR at 3-4 weeks. HCV exposure guidelines stress early identification to initiate appropriate follow-up, given developments in effective antiviral therapies.<br /><br />For infected HCWs concerning Hepatitis B, C, and HIV, the necessity of double gloving, expert panel consultations, and infection control measures are emphasized, adhering to SHEA and CDC guidelines to ensure safety and confidentiality. Dr. Russi's presentation underscores the need for stringent measures to minimize risks and the importance of updated practices in response to scientific advancements.

Keywords

bloodborne pathogens

HIV

HCV

healthcare workers

post-exposure prophylaxis

Needlestick Safety Act

antiretroviral therapies

HCV exposure guidelines

infection control

CDC guidelines