Patient-to-Patient Transmission of Bloodborne Pathogens in Health Care: The Price and Perils of Progress?

Abstract

The practice of medicine has changed dramatically over thepast 2 decades. The past 20 years have witnessed the intro-duction of interventional technologies that would—just a fewyears ago—have seemed unimaginable. Whereas such tech-nological advances are most often associated with increasedprecision of treatment and substantial decreases in morbidityand mortality, they are not without costs. Use of many ofthese new technologies requires sophisticated technical skillsand is often quite costly; in addition, maintenance and man-agement of new, complex equipment are often technicallycomplex. As medical devices have become more complex, sohave their cleaning and disinfection protocols.Another problem that has been engendered by increasinglysophisticated medical technology is a relatively blind relianceon the safety and efficacy of new (presumably safer) devicesand procedures. These 2 problems can work together to in-crease risk for patients and providers. Curiously, all the tech-nological advances of the late 20th and early 21st centurieshave not abrogated healthcare workers’ responsibilities to at-tend to the use of basic infection control techniques whileproviding patient care. For example, several epidemics of re-spiratory infections have been associated with inadequatecleaning and disinfection of bronchoscopes (occasionallycon-founded by problems relating to device design).