Management of Neurosurgical Instruments and Patients Exposed to Creutzfeldt-Jakob Disease

Details

• Alternative Title:
  Infect Control Hosp Epidemiol
• Personal Author:
  Belay, Ermias D. ; Blase, Jennifer ; Sehulster, Lynne M. ; Maddox, Ryan A. ; Schonberger, Lawrence B.
• Description:
  OBJECTIVE
  
  To summarize the approaches used to manage exposure of patients to inadequately sterilized neurosurgical instruments contaminated as a result of Creutzfeldt-Jakob disease (CJD).
  
  METHODS
  
  Information on past CJD exposure incidents reported to the Centers for Disease Control and Prevention (CDC) was aggregated and summarized. In addition, inactivation studies were reviewed, and data from selected publications were provided for reference.
  
  RESULTS
  
  Nineteen incidents of patient exposure to potentially CJD-contaminated instruments were reported to the CDC, including 17 that involved intracranial procedures and 2 that involved ophthalmologic procedures. In more than 50% of incidents, the neurosurgical procedures were performed for diagnostic work up of the index patients. At least 12 of the hospitals had multiple neurosurgical sets, and the CJD-contaminated instruments could not be identified in 11 of 19 hospitals. In 12 of 15 hospitals with neurosurgical incidents, a decision was made to notify patients of their potential exposure.
  
  CONCLUSIONS
  
  Neurosurgical instruments used for treatment of patients with suspected or diagnosed CJD or patients whose diagnosis is unclear should be promptiy identified and sterilized using recommended CJD decontamination protocols. Inability to trace instruments complicates appropriate management of exposure incidents. The feasibility of instituting instrument tracking procedures should be considered.
  
  
• Subjects:
  Adult Aged Aged, 80 And Over Creutzfeldt-Jakob Syndrome Decontamination Female Humans Male Middle Aged Neurosurgery Ophthalmologic Surgical Procedures Prions Sterilization Surgical Instruments

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• Source:
  Infect Control Hosp Epidemiol. 34(12):1272-1280
• Pubmed ID:
  24225612
• Pubmed Central ID:
  PMC4748700
• Document Type:
  Journal Article
• Funding:
  CC999999/Intramural CDC HHSUnited States/
• Volume:
  34
• Issue:
  12
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:396cf62f64b76dcca91ff4dc60d5c6d34f3677cd1a56989bfa0135f96436dcfc
• Download URL:
  https://stacks.cdc.gov/view/cdc/37956/cdc_37956_DS1.pdf
• File Type:
  [PDF - 197.90 KB ]