• 1

    Thompson ND, Perz JF, Moorman AC, et al: Nonhospital health care-associated hepatitis B and C virus transmission: United States, 1998–2008. Ann Intern Med 150: 33, 2009.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2

    Alter MJ: Healthcare should not be a vehicle for transmission of hepatitis C virus. J Hepatol 48: 2, 2008.

  • 3

    Allos BM, Schaffner W: Transmission of hepatitis B in the health care setting: the elephant in the room ... or the mouse? J Infect Dis 195: 1245, 2007.

  • 4

    Perz JF, Grytdal S, Beck S, et al: Case-control study of hepatitis B and hepatitis C in older adults: do healthcare exposures contribute to burden of new infections? Hepatology 57: 917, 2013.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5

    Wise ME, Marquez P, Sharapov U, et al: Outbreak of acute hepatitis B virus infections associated with podiatric care at a psychiatric long-term care facility. Am J Infect Control 40: 16, 2012.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6

    Centers for Disease Control and Prevention: Multiple outbreaks of hepatitis B virus infection related to assisted monitoring of blood glucose among residents of assisted living facilities—Virginia, 2009–2011. MMWR Morb Mortal Wkly Rep 61: 339, 2012.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7

    Rutala WA, Weber DJ, Thomann CA: Outbreak of wound infections following outpatient podiatric surgery due to contaminated bone drills. Foot Ankle 7: 350, 1987.

  • 8

    Toth BL: Methicillin Resistant Staphylococcus aureus Outbreak Associated With Injections at a Podiatry Clinic, Bureau of Epidemiology, Florida Department of Health, Tallahassee, 2002.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9

    Wenger JD, Spika JS, Smithwick RW, et al: Outbreak of Mycobacterium chelonae infection associated with use of jet injectors. JAMA 264: 373, 1990.

  • 10

    Rutala WA, Weber DJ; Healthcare Infection Control Practices Advisory Committee : Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008, US Dept of Health and Human Services, CDC, Atlanta, GA, 2008.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11

    Spaulding EH: Chemical Disinfection of Medical and Surgical Materials, Lea & Febiger, Philadelphia, 1968.

  • 12

    US Food and Drug Administration: FDA-cleared sterilants and high level disinfectants with general claims for processing reusable medical and dental devices - March 2009. Available at: http://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/ReprocessingofSingle-UseDevices/ucm133514.htm. Accessed January 20, 2015.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13

    Favero M, Bond W: “Sterilization, Disinfection, and Antisepsis in the Hospital,” in Manual of Clinical Microbiology, 5th Ed, edited by A Balows, Hausler WJ Jr, KL Herrmann, et al, p 183, American Society for Microbiology, Washington, DC, 1991.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14

    Favero M, Bond W: “Chemical Disinfection of Medical and Surgical Materials,” in Disinfection, Sterilization, and Preservation, 5th Ed, edited by SS Block, p 881, Lippincott Williams & Wilkins, Philadelphia, 2001.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15

    Kohn WG, Collins AS, Cleveland JL, et al: Guidelines for infection control in dental health-care settings: 2003. MMWR Recomm Rep 52: 1, 2003.

  • 16

    Australasian Podiatry Council: Infection prevention and control guidelines and policies 387 2012. Available at: http://www.cpd.apodc.com.au/activity/infection-prevention-and-control-guidelines-and-policies-2012. Accessed January 20, 2015.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17

    Public Health Agency of Canada: Infection control guidelines: foot care by health care providers. Can Commun Dis Rep 23S8, 1997.

  • 18

    Association for the Advancement of Medical Instrumentation: Comprehensive Guide to Steam Sterilization and Sterility Assurance in Health-care Facilities, Association for the Advancement of Medical Instrumentation, Arlington, VA, 2010.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19

    Perz JF, Thompson ND, Schaefer MK, et al: US outbreak investigations highlight the need for safe injection practices and basic infection control. Clin Liver Dis 14: 137, 2010.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20

    Mortimer PP: Away with multi-use vials! Aids 13: 1779, 1999.

  • 21

    World Health Organization: Injection safety: the SIGN alliance. Available at: http://www.who.int/injection_safety/sign/en. Accessed December 20, 2012.

  • 22

    Safe Injection Practices Coalition: One and Only Campaign. Available at: http://oneandonlycampaign.org. Accessed February 3, 2015.

  • 23

    Centers for Disease Control and Prevention: Injection safety. Available at: http://www.cdc.gov/injectionsafety. Accessed January 31, 2013.

  • 24

    Hughes RR: Syringe contamination following intramuscular and subcutaneous injections. J R Army Med Corps 87: 156, 1946.

  • 25

    Evans RJ, Spooner ET: A possible mode of transfer of infection by syringes used for mass inoculation. Br Med J 2: 185, 1950.

  • 26

    Fleming A, Ogilvie AC: Syringe needles and mass inoculation technique. Br Med J 1: 543, 1951.

  • 27

    Lutz CT, Bell CE Jr, Wedner HJ, et al: Allergy testing of multiple patients should no longer be performed with a common syringe. N Engl J Med 310: 1335, 1984.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 28

    Koepke JW, Reller LB, Masters HA, et al: Viral contamination of intradermal skin test syringes. Ann Allergy 55: 776, 1985.

  • 29

    Plott RT, Wagner RF Jr, Tyring SK: Iatrogenic contamination of multidose vials in simulated use: a reassessment of current patient injection technique. Arch Dermatol 126: 1441, 1990.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 30

    Trepanier CA, Lessard MR, Brochu JG, et al: Risk of cross-infection related to the multiple use of disposable syringes. Can J Anaesth 37: 156, 1990.

  • 31

    Druce JD, Locarnini SA, Birch CJ: Isolation of HIV-1 from experimentally contaminated multidose local anaesthetic vials. Med J Aust 162: 513, 1995.

  • 32

    Apetrei C, Becker J, Metzger M, et al: Potential for HIV transmission through unsafe injections. Aids 20: 1074, 2006.

  • 33

    Centers for Disease Control and Prevention: Acute hepatitis C virus infections attributed to unsafe injection practices at an endoscopy clinic–Nevada, 2007. MMWR Morb Mortal Wkly Rep 57: 513, 2008.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 34

    Siegel JD, Rhinehart E, Jackson M, et al: 2007 Guideline for isolation precautions: preventing transmission of infectious agents in health care settings. Am J Infect Control 35 (suppl 2): S65, 2007.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 35

    Centers for Disease Control and Prevention: Guide to infection prevention for outpatient settings: minimum expectations for safe care. Available at: http://www.cdc.gov/HAI/pdfs/guidelines/standards-of-ambulatory-care-7-2011.pdf. Accessed August 13, 2012.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 36

    Centers for Disease Control and Prevention: Questions about multi-dose vials. Available at: http://www.cdc.gov/injectionsafety/providers/provider_faqs_multivials.html. Accessed Decmber 27, 2012.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 37

    Boyce JM, Pittet D; Healthcare Infection Control Practices Advisory Committee; HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force: Guideline for hand hygiene in health-care settings: Recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force: Society for Healthcare Epidemiology of America/Association for Professionals in Infection Control/Infectious Diseases Society of America. MMWR Recomm Rep 51: 1, 2002.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 38

    Centers for Disease Control and Prevention: Hand hygiene in healthcare settings. Available at: http://www.cdc.gov/handhygiene. Accessed January 31, 2013.

  • 39

    Centers for Disease Control and Prevention: Protecting healthcare personnel. Available at: http://www.cdc.gov/HAI/prevent/ppe.html. Accessed January 31, 2013.

  • 40

    Sehulster L, Chinn RY; CDC; HICPAC: Guidelines for environmental infection control in health-care facilities: recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee (HICPAC). MMWR Recomm Rep 52: 1, 2003.

    • PubMed
    • Search Google Scholar
    • Export Citation

Infection Prevention and Control in the Podiatric Medical Setting

Challenges to Providing Consistently Safe Care

Matthew E. Wise Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, GA.

Search for other papers by Matthew E. Wise in
Current site
Google Scholar
PubMed
Close
 MPH, PhD
,
Elizabeth Bancroft Acute Communicable Disease Control Program, Los Angeles County Department of Public Health, Los Angeles, CA.

Search for other papers by Elizabeth Bancroft in
Current site
Google Scholar
PubMed
Close
 MD, SM
,
Ernest J. Clement Bureau of Healthcare Associated Infections, New York State Department of Health, Albany, NY.

Search for other papers by Ernest J. Clement in
Current site
Google Scholar
PubMed
Close
 RN, MSN, CIC
,
Susan Hathaway Acute Communicable Disease Control Program, Los Angeles County Department of Public Health, Los Angeles, CA.

Search for other papers by Susan Hathaway in
Current site
Google Scholar
PubMed
Close
 RN, MPH
,
Patricia High Public Health Nursing, Clinic Services, Ocean County Health Department, Toms River, NJ.

Search for other papers by Patricia High in
Current site
Google Scholar
PubMed
Close
 MHS, MCHES
,
Moon Kim Acute Communicable Disease Control Program, Los Angeles County Department of Public Health, Los Angeles, CA.

Search for other papers by Moon Kim in
Current site
Google Scholar
PubMed
Close
 MD, MPH
,
Emily Lutterloh Bureau of Healthcare Associated Infections, New York State Department of Health, Albany, NY.

Search for other papers by Emily Lutterloh in
Current site
Google Scholar
PubMed
Close
 MD, MPH
,
Joseph F. Perz Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, GA.

Search for other papers by Joseph F. Perz in
Current site
Google Scholar
PubMed
Close
 DrPH
,
Lynne M. Sehulster Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, GA.

Search for other papers by Lynne M. Sehulster in
Current site
Google Scholar
PubMed
Close
 PhD
,
Clara Tyson Acute Communicable Disease Control Program, Los Angeles County Department of Public Health, Los Angeles, CA.

Search for other papers by Clara Tyson in
Current site
Google Scholar
PubMed
Close
 RN, MSN
,
Mary Beth White-Comstock Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, GA.

Search for other papers by Mary Beth White-Comstock in
Current site
Google Scholar
PubMed
Close
 RN, CIC
, and
Barbara Montana Communicable Disease Service, New Jersey Department of Health, Trenton, NJ.

Search for other papers by Barbara Montana in
Current site
Google Scholar
PubMed
Close
 MD, MPH

Unsafe practices are an underestimated contributor to the disease burden of bloodborne viruses. Outbreaks associated with failures in basic infection prevention have been identified in nonhospital settings with increased frequency in the United States during the past 15 years, representing an alarming trend and indicating that the challenge of providing consistently safe care is not always met. As has been the case with most medical specialties, public health investigations by state and local health departments, and the Centers for Disease Control and Prevention, have identified some instances of unsafe practices that have placed podiatric medical patients at risk for viral, bacterial, and fungal infections. All health-care providers, including podiatric physicians, must make infection prevention a priority in any setting in which care is delivered.

The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

Corresponding author: Matthew E. Wise, MPH, PhD, Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, 1600 Clifton Road NE, MS A-35, Atlanta, GA 30333. (E-mail: cxx4@cdc.gov)
Save