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Int. J. Environ. Res. Public Health 2018, 15(2), 238; https://doi.org/10.3390/ijerph15020238

Near-Patient Sampling to Assist Infection Control—A Case Report and Discussion

1
Clinical Microbiology, University Hospitals of Leicester NHS Trust, Leicester LE1 5WW, UK
2
Infection, Immunity and Inflammation, University of Leicester, Leicester LE1 7RH, UK
3
Infection Prevention and Control, University Hospitals of Leicester NHS Trust, Leicester LE1 5WW, UK
4
Leicester Children’s Hospital, University Hospitals of Leicester NHS Trust, Leicester LE1 5WW, UK
5
Infectious Diseases Unit, University Hospitals of Leicester NHS Trust, Leicester LE1 5WW, UK
*
Author to whom correspondence should be addressed.
Received: 4 December 2017 / Revised: 26 January 2018 / Accepted: 29 January 2018 / Published: 31 January 2018
(This article belongs to the Special Issue Environmental Hygiene)
Full-Text   |   PDF [949 KB, uploaded 31 January 2018]   |  

Abstract

Air sampling as an aid to infection control is still in an experimental stage, as there is no consensus about which air samplers and pathogen detection methods should be used, and what thresholds of specific pathogens in specific exposed populations (staff, patients, or visitors) constitutes a true clinical risk. This case report used a button sampler, worn or held by staff or left free-standing in a fixed location, for environmental sampling around a child who was chronically infected by a respiratory adenovirus, to determine whether there was any risk of secondary adenovirus infection to the staff managing the patient. Despite multiple air samples taken on difference days, coinciding with high levels of adenovirus detectable in the child’s nasopharyngeal aspirates (NPAs), none of the air samples contained any detectable adenovirus DNA using a clinically validated diagnostic polymerase chain reaction (PCR) assay. Although highly sensitive, in-house PCR assays have been developed to detect airborne pathogen RNA/DNA, it is still unclear what level of specific pathogen RNA/DNA constitutes a true clinical risk. In this case, the absence of detectable airborne adenovirus DNA using a conventional diagnostic assay removed the requirement for staff to wear surgical masks and face visors when they entered the child’s room. No subsequent staff infections or outbreaks of adenovirus have so far been identified. View Full-Text
Keywords: airborne; transmission; air sampling; respiratory; adenovirus; infection control; limit of detection; sensitivity; face masks; personal protective equipment airborne; transmission; air sampling; respiratory; adenovirus; infection control; limit of detection; sensitivity; face masks; personal protective equipment
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).
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Tang, J.W.; Hoyle, E.; Moran, S.; Pareek, M. Near-Patient Sampling to Assist Infection Control—A Case Report and Discussion. Int. J. Environ. Res. Public Health 2018, 15, 238.

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