Prevalence of blood-borne pathogens in an urban, university-based general surgical practice

Eric S. Weiss, Martin A. Makary, Theresa Wang, Dora Syin, Peter J. Pronovost, David Chang, Edward E. Cornwell, L. D. Britt, Martin Croce, Lewis M. Flint, Raleigh R. White IV, Richard J. Howard

Research output: Contribution to journalArticle

41 Citations (Scopus)

Abstract

Objective: To measure the current prevalence of blood-borne pathogens in an urban, university-based, general surgical practice. Summary Background Data: Human immunodeficiency virus (HIV), hepatitis B, and hepatitis C represent significant occupational hazards to the surgeon. While the incidence of these blood-borne pathogens is increasing in the general population, little is known about the current prevalence of these exposures among patients presenting for surgery. Methods: We studied 709 consecutive operative cases (July 2003 to June 2004) in a university practice that provides all inpatient, emergency department, and outpatient consultative general surgical services. Trauma cases and bedside procedures were excluded. Data collected included HIV, hepatitis B and C test results, type of operation, age, sex, and history of intravenous drug use. Results: Testing for blood-borne pathogens was performed in 53% (N = 373) of 709 patients based on abnormal liver function tests, neutropenia, history of IV drug use, or patient request. Thirty-eight percent of all operations (142/373) were found to involve a bloodborne pathogen when tested: HIV (26%), hepatitis B (4%), hepatitis C (35%), and coinfection with HIV and hepatitis C (17%). Forty-seven percent of men tested positive for at least 1 blood-borne pathogen. Seventy-three different types of operations were performed, ranging from Whipple procedures to amputations. Soft-tissue abscess procedures 48% (34/71) and lymph node biopsies 67% (10/15) (P < 0.01) were most often associated with blood-borne pathogens. Infections were more common among men (P < 0.01), patients 41 to 50 years of age (P < 0.01), and patients with a history of intravenous drug use (P < 0.01). Conclusions: HIV and hepatitis C infections are common in an urban university general surgical practice, while hepatitis B is less common. In addition, certain operations are associated with significantly increased exposure rates. Given the high incidence of these infections, strategies such as sharpless surgical techniques should be evaluated and implemented to protect surgeons from blood-borne pathogens.

Original languageEnglish (US)
Pages (from-to)803-809
Number of pages7
JournalAnnals of surgery
Volume241
Issue number5
DOIs
StatePublished - May 1 2005

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Blood-Borne Pathogens
General Practice
Hepatitis C
Hepatitis B
HIV
Infection
Pharmaceutical Preparations
Liver Function Tests
Incidence
Neutropenia
Coinfection
Amputation
Abscess
Hospital Emergency Service
Inpatients
Outpatients
Lymph Nodes
Biopsy
Wounds and Injuries

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Weiss, E. S., Makary, M. A., Wang, T., Syin, D., Pronovost, P. J., Chang, D., ... Howard, R. J. (2005). Prevalence of blood-borne pathogens in an urban, university-based general surgical practice. Annals of surgery, 241(5), 803-809. https://doi.org/10.1097/01.sla.0000161174.71460.1f

Prevalence of blood-borne pathogens in an urban, university-based general surgical practice. / Weiss, Eric S.; Makary, Martin A.; Wang, Theresa; Syin, Dora; Pronovost, Peter J.; Chang, David; Cornwell, Edward E.; Britt, L. D.; Croce, Martin; Flint, Lewis M.; White IV, Raleigh R.; Howard, Richard J.

In: Annals of surgery, Vol. 241, No. 5, 01.05.2005, p. 803-809.

Research output: Contribution to journalArticle

Weiss, ES, Makary, MA, Wang, T, Syin, D, Pronovost, PJ, Chang, D, Cornwell, EE, Britt, LD, Croce, M, Flint, LM, White IV, RR & Howard, RJ 2005, 'Prevalence of blood-borne pathogens in an urban, university-based general surgical practice', Annals of surgery, vol. 241, no. 5, pp. 803-809. https://doi.org/10.1097/01.sla.0000161174.71460.1f
Weiss, Eric S. ; Makary, Martin A. ; Wang, Theresa ; Syin, Dora ; Pronovost, Peter J. ; Chang, David ; Cornwell, Edward E. ; Britt, L. D. ; Croce, Martin ; Flint, Lewis M. ; White IV, Raleigh R. ; Howard, Richard J. / Prevalence of blood-borne pathogens in an urban, university-based general surgical practice. In: Annals of surgery. 2005 ; Vol. 241, No. 5. pp. 803-809.
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abstract = "Objective: To measure the current prevalence of blood-borne pathogens in an urban, university-based, general surgical practice. Summary Background Data: Human immunodeficiency virus (HIV), hepatitis B, and hepatitis C represent significant occupational hazards to the surgeon. While the incidence of these blood-borne pathogens is increasing in the general population, little is known about the current prevalence of these exposures among patients presenting for surgery. Methods: We studied 709 consecutive operative cases (July 2003 to June 2004) in a university practice that provides all inpatient, emergency department, and outpatient consultative general surgical services. Trauma cases and bedside procedures were excluded. Data collected included HIV, hepatitis B and C test results, type of operation, age, sex, and history of intravenous drug use. Results: Testing for blood-borne pathogens was performed in 53{\%} (N = 373) of 709 patients based on abnormal liver function tests, neutropenia, history of IV drug use, or patient request. Thirty-eight percent of all operations (142/373) were found to involve a bloodborne pathogen when tested: HIV (26{\%}), hepatitis B (4{\%}), hepatitis C (35{\%}), and coinfection with HIV and hepatitis C (17{\%}). Forty-seven percent of men tested positive for at least 1 blood-borne pathogen. Seventy-three different types of operations were performed, ranging from Whipple procedures to amputations. Soft-tissue abscess procedures 48{\%} (34/71) and lymph node biopsies 67{\%} (10/15) (P < 0.01) were most often associated with blood-borne pathogens. Infections were more common among men (P < 0.01), patients 41 to 50 years of age (P < 0.01), and patients with a history of intravenous drug use (P < 0.01). Conclusions: HIV and hepatitis C infections are common in an urban university general surgical practice, while hepatitis B is less common. In addition, certain operations are associated with significantly increased exposure rates. Given the high incidence of these infections, strategies such as sharpless surgical techniques should be evaluated and implemented to protect surgeons from blood-borne pathogens.",
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AU - Chang, David

AU - Cornwell, Edward E.

AU - Britt, L. D.

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N2 - Objective: To measure the current prevalence of blood-borne pathogens in an urban, university-based, general surgical practice. Summary Background Data: Human immunodeficiency virus (HIV), hepatitis B, and hepatitis C represent significant occupational hazards to the surgeon. While the incidence of these blood-borne pathogens is increasing in the general population, little is known about the current prevalence of these exposures among patients presenting for surgery. Methods: We studied 709 consecutive operative cases (July 2003 to June 2004) in a university practice that provides all inpatient, emergency department, and outpatient consultative general surgical services. Trauma cases and bedside procedures were excluded. Data collected included HIV, hepatitis B and C test results, type of operation, age, sex, and history of intravenous drug use. Results: Testing for blood-borne pathogens was performed in 53% (N = 373) of 709 patients based on abnormal liver function tests, neutropenia, history of IV drug use, or patient request. Thirty-eight percent of all operations (142/373) were found to involve a bloodborne pathogen when tested: HIV (26%), hepatitis B (4%), hepatitis C (35%), and coinfection with HIV and hepatitis C (17%). Forty-seven percent of men tested positive for at least 1 blood-borne pathogen. Seventy-three different types of operations were performed, ranging from Whipple procedures to amputations. Soft-tissue abscess procedures 48% (34/71) and lymph node biopsies 67% (10/15) (P < 0.01) were most often associated with blood-borne pathogens. Infections were more common among men (P < 0.01), patients 41 to 50 years of age (P < 0.01), and patients with a history of intravenous drug use (P < 0.01). Conclusions: HIV and hepatitis C infections are common in an urban university general surgical practice, while hepatitis B is less common. In addition, certain operations are associated with significantly increased exposure rates. Given the high incidence of these infections, strategies such as sharpless surgical techniques should be evaluated and implemented to protect surgeons from blood-borne pathogens.

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