What universal precautions should be taken at high-risk autopsies with drug resistant infections present?

Updated: May 20, 2019
  • Author: Jeffrey S Nine, MD; Chief Editor: Kim A Collins, MD, FCAP  more...
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Answer

Methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus faecium (VREF), multidrug-resistant Pseudomonas aeruginosa, multidrug-resistant Acinetobacter baumannii-haemolyticus, and other multidrug-resistant bacteria that represent normal flora are a concern at autopsy, but the risk that these agents will cause illness in those performing an autopsy is not high. The concern is to avoid spreading these agents outside the autopsy room. To prevent such spread, protective garments that have blood or body fluids on them should be taken off before leaving the autopsy room.

More recently, the emergence of multidrug-resistant Candida auris, a fungus that spreads in healthcare facilities, has become a serious health threat not only in the United States but globally. [9]  This fungus is easily misidentified and requires specialized laboratory technology for identification. Mortality is high in those with invasive C auris infection (approximately one in three). [9]  Healthcare facilities or laboratories that suspect they have a patient with C auris infection should contact state or local public health authorities and the Centers for Disease Control and Prevention (CDC) (candidaauris@cdc.gov) immediately for guidance. [10] All healthcare personnel, including laboratory personnel and prosectors, should be aware of and perform appropriate hand hygiene, appropriate environmental disinfection with Environmental Protection Agency (EPA)-registered hospital-grade disinfectant effective against Clostridioides difficile spores, and the use of contact precautions, such as protective gowns and gloves help to prevent transmission, among others. [11]  


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