Infection Control Precautions and Anesthesia

Abstract

In Response: We appreciate the comments by Dr. Arron regarding our survey [1]. Dr. Arron suggests that Question 27 of our survey may have resulted in an underreporting of the degree to which anesthesiologists clean laryngoscope blades appropriately. His point is well taken in that we did not distinguish between high and low levels of disinfection as recommended by the Centers for Disease Control (CDC). As Dr. Arron suggests, this may have resulted in an underreporting of compliance with respect to the practice of cleaning laryngoscope blades. However, if indeed this was true, then it further highlights the need for stricter adherence to the CDC's guidelines. Although we concur that this particular question may not have been definitive, we disagree with Dr. Arron's suggestion that the questionnaire as a whole was therefore misleading. Dr. Arron makes some important points with respect to the expectation of anesthesiologists to meet at least the minimum standards of care regarding perioperative control of infection. In a previous report which represented the first phase of this study, 88% of anesthesiologists reported that they always complied with the CDC guidelines for the prevention of occupational transmission of human immunodeficiency virus (HIV) and hepatitis B virus (HBV) when presented with a known HIV- or HBV-infected patient, but only 24.7% adhered to the guidelines when the patient was considered low risk [2]. Despite the fact that there is no convincing evidence to support a direct cause and effect relationship between anesthesia practice and infection, anesthesiologists can ill afford to become complacent and, as Dr. Arron points out, we should strive to adhere to the recommended guidelines until we can be persuaded that less stringent measures can be adopted safely. Alan R. Tait, PhD Department of Anesthesiology University of Michigan Medical Center Ann Arbor, MI 48109 Dale B. Tuttle, MBA Department of Management Michigan State University East Lansing, MI 48824