Skip to main content
Log in

Standard precautions and post exposure prophylaxis for preventing infections

  • Special Article
  • Published:
The Indian Journal of Pediatrics Aims and scope Submit manuscript

Abstract

In health care set up, risk of acquiring infection by both patients and health care worker (HCW) from each other is fairly high. Despite progress, hospital acquired infections (HAI) are a problem in both developed and developing countries and are an important cause of death. Many different microbes cause HAI in both patients and HCW; these include various commensals, pathogenic bacteria, viruses, parasites, and fungi. Among these HIV, hepatitis B, and hepatitis C are of major significance to HCW. ‘Standard precautions’ have now replaced the term ‘universal precautions’, and are designed to reduce the risk of transmission of microorganisms in health care set-up from both recognized and unrecognized sources. Ultimate aim is to reduce the risk of disease transmission in the healthcare setting, both to the patient and the provider, and thus reduce morbidity. This applies to all patients, regardless of their diagnosis and expands the coverage of universal precautions by recognizing that any body fluid may contain contagious and harmful microorganisms. This article reviews the standard precautions and discusses current guidelines on post exposure prophylaxis (PEP)

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Ducel G, Fabry J, Nicolle K. World Health Organization. Department of Communicable Disease, Surveillance and Response. Prevention of hospital-acquired infections. WHO/ 4 CDS/CSR/EPH/2002.12.

  2. Benenson AS. Control of communicable disease manual. 16th edn, Washington DC, American public health association 1995; 150–155.

    Google Scholar 

  3. Tikhomirov E. WHO program for the control of hospital infection.Chemotherapy 1987; 3:148–151.

    Google Scholar 

  4. White RT, Ducel G, Kereselidze T, Tikomirov E. An international survey of the prevalence of hospital acquired infection.J HospInfect 1988; 11:43–48.

    Google Scholar 

  5. Leon S. The needs of developing countries and resources required.J HospInfect 1991; 18 (suppl): 376–381.

    Article  Google Scholar 

  6. Plowman R, Graves N, Griffin M, Roberts JA, Swan A, Cookson B et al. The socioeconomic burden of hospital acquired infection. London School of Hygiene and Tropical Medicine, London 1999 www.eurosurveillance.org/em/ v05n04/0504-225.asp-20k.

  7. Wenzel RP. The economics of nosocomial infection.J HospInfect 1995; 31: 79–87.

    Article  PubMed  CAS  Google Scholar 

  8. Center for disease control and prevention. HIV/AIDS surveillance report. 1993:(13) 2.http://www.cdc.gov/hiv/ stats/hasrl302/table3.htm.

  9. Gerberdang JL, Bryant CE, Nelson K. Risk of transmitting the Human immunodeficiency virus, Cytomegalovirus, and Hepatitis B virus to health care workers exposed to patient with AIDS and AIDS related condition.J Infect Dis 1987:156: 1–8.

    Google Scholar 

  10. Henderson DK, Fahey BJ, Willy M, Schmitt JM, Carey K, Koziol DEet al. Occupational transmission of Human immunodeficiency virus type 1 (HIV-1) associated with clinical exposures: a prospective evaluation.Ann Intern Med 1990; 113:740–446.

    PubMed  CAS  Google Scholar 

  11. Markus R. Cooperative needle stick study group. Surveillance of health care workers exposed blood from patients infected with HIV virus.N Eng J Med 1988; 319:1118–23.

    Article  Google Scholar 

  12. Simmonds RJ. Medical issues related to caring for HIV infected children in and out of the home.Pediatr Infect Dis J 1993; 12(10): 845–885.

    Article  Google Scholar 

  13. Inter disciplinary clinical practical manual, John Hopkins Hospital Policy, IFCD15 Effective 10/01(internet).

  14. Semmelweis I. The etiology, the concept, and the prophylaxis of childhood fevers (excerpts): Editors: Buck C, Liops A Najeera E, Terris M, eds.The Challenge Of Epidemiology Issue and Selected Readings. Washington. PAHO scientific publication. 1998; 46–59.

    Google Scholar 

  15. Rotter ML. 150 years of hand disinfection.Semmelweis’ Heritage Hygiene Medicine 1997; 22:332–339.

    Google Scholar 

  16. Rotter ML. Hand washing and hand disinfection. In Maygall G, eds.Hospital Epidemiology and Infection Control. 1st edition. Baltimore. Williams and Wilkins 1996; pp 1052–1068.

    Google Scholar 

  17. Lowbury EJ, Lilly HA, Bull JP. Disinfection of hands: removal of transcutaneous organisms.Br Med J 1964; 2:230.

    Article  PubMed  CAS  Google Scholar 

  18. Ayliffe GAJ, Babb JR, Quoraishi AH. A test for hygienic hand disinfection.J Clin Path 1978; 31:923–928.

    Article  PubMed  CAS  Google Scholar 

  19. Rotter ML, Koller W. European tests for evaluation of the efficiency of procedures for the antiseptic hand wash.Hygiene Medizix 1991; 16:4–12.

    Google Scholar 

  20. Larson E. Association for Professionals in Infection Control and Epidemiology, Inc, APIC guidelines for hand washing and hand antisepsis in health care settings.Am J Infect Cont 1995; 23(4): 251–269.

    Article  CAS  Google Scholar 

  21. Rotter ML. Hand washing and hand disinfection. In Mayhall CG, eds.Hospital Epidemiologiy and Infection Control. 2nd edn, Philadhelphia; Lippincott, Williams and Wilkins, 1999; 1339–1385.

    Google Scholar 

  22. Pittet D. Improving hand adherence to hand hygiene practices. A multi disciplinary approach.Emerge Infect Dis 2001; 7(2): 234–240.

    CAS  Google Scholar 

  23. Gamer JS. Guidelines for isolation precautions in hospitals.Infect Cont Hosp Epidemiol 1996; 17:53–80.

    Article  Google Scholar 

  24. Garner JS, Favero MS. CDC guidelines for hand washing and hospital environmental control.Infect Cont Hosp Epidemiol 1986; 7:232–243.

    Google Scholar 

  25. Sprunt K, Redman W, Leidy G. Antibacterial effectiveness of routine hand washing.Pediatrics 1973; 52:264–271.

    PubMed  CAS  Google Scholar 

  26. Larson E. The casual relationship between hand washing and risk of infection. Examination of evidence.Infect Cont Hosp Epidemiol 1998; 9:28–36.

    Google Scholar 

  27. Bryan JL, Cohran J, Larson EL. Hand washing and infection revisited.N Clin North Am 1995; 4:675–625.

    Google Scholar 

  28. Black RE, Dykes AC, Anderson KE, Wells JG, Sinclair SP, Gary GW Jr,et al. Hand washing to prevent disease in day care centers.Am J Epidemiol 1981; 113(4): 445–451.

    PubMed  CAS  Google Scholar 

  29. Specialist’s training and reference module. NACO, Ministry Of Health and Family Welfare, New Delhi, India. 2002; 17:170.

  30. Simmons B, Bryant J, Weman K, Spencer L, Arhcarlt K. The role of hand washing in prevention of endemic ICU infection.Infect Cont Hosp Epidemiol 1990; 11:589–594.

    Article  CAS  Google Scholar 

  31. Ward V, Witson J, Taylor L, Cookson D, Glynn A. Preventing hospital acquired infection. Clinical Guidelines London public health laboratory guidelines. 1997; 5–9.

  32. Teare EL, Cookson B, French GL, Jenner EA, Scott S, Pallett Det al. UK hand washing initiative.J Hosp Infect 1999; 43:1–3.

    Article  PubMed  CAS  Google Scholar 

  33. John MB, Pittet D. Guidelines for hand hygiene in health care settings. Recommendations of health care infection control practicing advisory committee and the HICPAC/SHEA/ APIC/IDSA. Hand Hygiene Task Force. Part II. Recommendations 2001.

  34. Department of health. Standard principles for preventing hospital acquired infection.J Hosp Infect 2001:47: S21–37.

    Article  Google Scholar 

  35. American Academy of Pediatrics. Committee on infectious disease and committee on practice and ambulatory medicine. Infection control in physicians’ office.Pediatrics 2000; 105 (6): 1361–1370.

    Article  Google Scholar 

  36. Ducel G. Foundation hygiene Geneva, Switzerland.Prevention of Hospital Acquired Infection. A practical guide. IInd edn. WHO/CDS/CIR/EPH 2002,12

  37. Pratt RJ, Pellowe C, Loveday HP, Robinson N, Smith GW, Barret SPet al. The EPIC Project. Developing National Evidence based guidelines for preventing health care associated infection.J Hosp Infect 2001; 47: S3-S4.

    Article  PubMed  Google Scholar 

  38. Satpathy S, Pandhi RK.Manual for Hospital Waste Management at AIIMS Hospital. 1–24.

  39. Larson E, Kretzer EK. Compliance with hand washing and barrier prevention.J Hosp Infect 1995; 30: 88–106.

    Article  PubMed  Google Scholar 

  40. Sproat LJ, Inglis TJ. A multicentric survey of hand hygiene practice in ICU.J Hosp Infect 1994; 26:137–148.

    Article  PubMed  CAS  Google Scholar 

  41. Kretzer EK, Larson E. Behavioural intervention to improve infection control.Am J Infect Cont 1998; 26: 245–253.

    Article  CAS  Google Scholar 

  42. Larson E, Killein M. Factors influencing hand washing. Behavior of patient care personnel.Am J Infect Cont 1982; 10: 93–99.

    Article  CAS  Google Scholar 

  43. Petit D, Mourouga P, Perneger TV. Members of infection control program. Compliance with hand washing in a teaching hospital.Ann Intern Med 1999; 130:126–130.

    Google Scholar 

  44. Gershon RRM, Karkashian C, Felknor S. Universal Precautions: An update.Heart Lung 1994; 23: 352–358.

    PubMed  CAS  Google Scholar 

  45. Preston GA, Larson EL, Stamm W. The effect of private isolation rooms on patient care practices, colonization and infection in an intensive care unit.Am J Med 1981; 70:641–645.

    Article  PubMed  CAS  Google Scholar 

  46. Albert RK, Condie F. Hand-washing patterns in medical intensive care units.N Eng J Med 1981; 304:1465.

    Article  CAS  Google Scholar 

  47. Meengs MR, Giles BK, Chisholm CD, Cordell WH, Nelson DR., Hand washing frequency in an emergency department.J Emerg Nurs 1994; 20:183–188.

    PubMed  CAS  Google Scholar 

  48. Donowitz L. Handwashing technique in a pediatric intensive care unit.Am J Dis Child 1987; 141:683–685.

    PubMed  CAS  Google Scholar 

  49. Casewell M, Phillips I. Hands as route of transmission for Klebsiella species.Br Med J 1977; 2:1315–1317.

    PubMed  CAS  Google Scholar 

  50. Maki D, Hecht J. Antiseptic containing hand-washing agents reduces nosocomial infections: a prospective study [Abstract nol88]. Program and abstracts of the 22nd Interscience Conference of Antimicrobial Agents and Chemotherapy, Miami, Oct 4–6, 1982. Washington, DC: American Society for Microbiology.

    Google Scholar 

  51. Massanari RM, Heirholzer WJJ. A crossover comparison of Antiseptic soaps on nosocomial infection rates in intensive care units.Am J Infect Control 1984; 12:247–248.

    Google Scholar 

  52. Webster J, Faoagali JL, Cartwright D. Elimination of methicillin resistant Staphylococcus aureus from a neonatal intensive care unit after hand washing with triclosan.J Paed Child Health 1994; 30:59–64.

    CAS  Google Scholar 

  53. Zafar AB, Butler RC, Reese DJ, Gaydos LA, Mennonna PA. Use of 0.3% triclosan (Bacti-Stat) to eradicate an outbreak of methicillin resistant Staphylococcus aureus in a neonatal nursery.Am J Infect Control 1995; 23:200–208.

    Article  PubMed  CAS  Google Scholar 

  54. Pittet D, Hugonnet S, Harbarth S, Mourouga P, Sauvan V, Touveneau Set al. Effectiveness of a hospital-wide programme to improve compliance with hand hygiene.Lancet 2000; 356: 1307–1312.

    Article  PubMed  CAS  Google Scholar 

  55. Ippolito G, Puro V, De Carli G. Italian Study Group on Occupational Risk of HIV Infection. The risk of occupational human immunodeficiency virus in health care workers.Arch Int Med 1993; 153:1451–1458.

    Article  CAS  Google Scholar 

  56. Centre for Disease Control. Update: human immunodeficiency virus infections in health-care workers exposed to blood of infected patients.MMWR 1987; 36:285–289.

    Google Scholar 

  57. Fahey BJ, Koziol DE, Banks SM, Henderson DK. Frequency of nonparenteral occupational exposures to blood and body fluids before and after universal precautions training.Am J Med 1991; 90:145–153.

    PubMed  CAS  Google Scholar 

  58. Cardo DM, Culver DH, Ciesielski CA, Srivastava PU, Marcus R, Abiteboul Det al. A case-control study of HIV seroconversion in health care workers after percutaneous exposure.N Eng J Med 1997; 337:1485–1489.

    Article  CAS  Google Scholar 

  59. Updated U.S. Public Health Service Guidelines for the Management of Occupational Exposures to HBV, HCV, and HIV and Recommendations for Post exposure Prophylaxis.MMWR 2001; 50S: 1–42.

  60. Saba J. PETRA Trial Study Team. Interim analysis of early efficacy of three short ZDV/3TC combination regimens to prevent mother-to-child transmission of HIV-1: The PETRA trial [Abstract S-7]. In: Program and abstracts of the 6th Conference on Retroviruses and Opportunistic Infections. Chicago, IL: Foundation for Retrovirotogy and Human Health in scientific collaboration with the National Institute of Allergy and Infectious Diseases and CDC, 1999 RR11; 1–42.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Rakesh Lodha.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sridhar, M.R., Boopathi, S., Lodha, R. et al. Standard precautions and post exposure prophylaxis for preventing infections. Indian J Pediatr 71, 617–625 (2004). https://doi.org/10.1007/BF02724121

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02724121

Key words

Navigation