Prevention of nosocomial disease
Author:
Barnes AJ
Date: 3 July 2000
Abstract:
The prevention of nosocomial aspergillosis is problematic, not least because recent years have seen an inexorable increase in the numbers of highly immunocompromised patients potentially at risk in a hospital environment. Neutropenic patients, notably allogeneic transplant recipients, are at risk for invasive infection; but recent reports also highlight the occurrence of disease due to Aspergillus species in neonates, and other categories of immunosuppressed patients, including renal and rheumatology patients on aggressive immunosuppressive regimens and patients with late-stage HIV disease (8-12). In addition, implementation of preventive measures may be costly, disruptive, and involve diverse groups of hospital personnel. There are currently no UK or European guidelines in this area, so much of this article is based on the US, CDC Guidelines, updated in 1997 (1).What follows is an attempt to briefly summarise those guidelines on prevention of nosocomial aspergillosis, and to highlight some of the difficult issues which may arise – issues which have led some experts to ask whether the prevention of invasive aspergillosis IA) is even an realistic aim (3).
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