Isolation of chronic hemodialysis patients

Isolation of chronic hemodialysis patients

Chronic hemodialysis patients are patient which need to visit the hemodialysis unit mainly three times weekly and prone to infected with blood borne pathogen and also to infect others if they are infected due to carless practice and not following the proper isolation also at the same time abusing the isolation has a psychological, financial and utilization impact so isolation need to be unified based on recommendations we have to know that the relative risk of airing infection for patient and HCWs is less in both HCV & HIV more than HBV

Isolation of chronic hemodialysis patients

Isolation of chronic hemodialysis patients

 

  1. HIV infection from an exposure occurs which representing  0.2%–0.4%.
  2. HCV infection from an exposure occurs at a rate of less than 1%.
  3. HBV infection from an exposure occurs at a rate of up to 30%.

So the lowest rate is for the HIV infection and the highest one is for HBV infection.

 

HIV Positive Patients

 

HIV infected patient don’t need to be isolated from other patients (infected with HIV, HCV or not infected) or even using a separated dedicated dialysis machine even they can participate in dialyzer reuse , standard precautions is needed to be practice with those patients

 

HCV Positive Patients

 

HCV infected patient is also need to be treated like HIV positive patient in the term of isolation, chronic HD patient with positive HCV infection no need to be isolated or separate or dedicate machine for them ,only implement the standard precaution while dealing inside the HD unit

Remember: Although isolation of HCV-infected patients is not recommended, routine testing for ALT and anti-HCV is important for monitoring transmission within centers and ensuring that appropriate precautions are being properly and consistently used.

 

HBV Positive Patients

 

HBV infected patient need to be isolated …why?! It is clearly that the virus particle can persist on environmental surfaces for more than 7 days in the room temp plus 10 viral particles are enough to cause infection (low viral load is needed to cause infection) so it is easy to be transmitted and cause infection

For those patient we need to;

• Patients are placed in a private room or segregated area for HBV positive patients only.

• Dedicated dialysis machine is used for HBV-positive patients only.

• Dialyzers are discarded in biomedical waste after treatment.

• Gown and gloves are required for each entry into room.

• Mask with eye protection is required for cannulation and decannulation.

• Staff caring for HBV patients cannot care for HBV susceptible patients at the same time.

• Staff caring HBV patients should be HBV-immune anti-HBs (>10 mIU/mL).

 

Vaccination is the key to prevent the transmission (plus the standard precaution and patient isolation) the Hepatitis B vaccine need to be administered to all HCWs and the patient who are HBV negative and the immune response need to be measured 1-2 months after the third dose

 

 Reference

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