akinohanayuki ブログ

学位を持っても、センスのない、感染制御専門薬剤師のブログ.  I have Ph.D. but less sense ID pharmacist.





UpToDate より引用

The main occupational risk for acquiring a bloodborne pathogen is a percutaneous sharps injury with a contaminated object. Mucous membrane exposure to blood or other potentially infectious material can also transmit hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV). 

●The two most common devices involved in injuries include disposable syringes and suture needles. These sharp devices are most commonly used for suturing, drawing venous blood, and administering injections.

●The risk that a healthcare worker will acquire a bloodborne pathogen as a result of an occupational exposure will depend upon several factors, including the prevalence of the infectious agent in the patient population, the nature of the exposure, and the availability of pre- and post-exposure prophylaxis.

●For individuals who are not immune to HBV, the risk of developing serologic evidence of HBV infection ranges from 23 to 62 percent after a percutaneous injury from a hepatitis B surface antigen-positive source patient. 

●The Centers for Disease Control and Prevention estimates the average incidence of HCV seroconversion to be 1.8 percent (range, 0 to 7 percent) after a needle stick or sharps exposures from a HCV-positive source. 

●All healthcare personnel (HCP) should be immunized against hepatitis B virus. Pre-exposure prophylaxis is not available for hepatitis C infection.

●After exposure to a bloodborne pathogen, exposed mucous membranes should be flushed with water. Wounds and skin sites that have been in contact with blood or body fluids should be washed with soap and water. 

Post-exposure prophylaxis with the hepatitis B vaccine and/or hepatitis B immune globulin should be administered to HCP who are not immune to HBV virus. The type of prophylaxis is determined by their vaccine status. 

●There is no post-exposure prophylaxis for persons exposed to HCV blood or contaminated body fluids. Thus, HCV testing should be performed to identify infection early in its course.