1392. Management of Occupational Exposures to Biological Fluids at the “Hospital del Trabajador de Santiago, Chile: Prospective Follow- up.
Session: Poster Abstract Session: HAI: Occupational Health
Friday, October 28, 2016
Room: Poster Hall
Posters
  • ensayo final Poster IDweek 2016 ACP HT.pdf (314.6 kB)
  • Background: Occupational exposure to biological fluids (OEBF) is a health concern, especially among healthcare workers (HCWs) because it constitutes a risk of transmission of blood-borne viruses like HIV, HBV and HCV. However, no recent Latin-American series provide an updated perspective on the problem.

    Methods: All HCWs attended at emergency room with diagnosis of OEBF, from Jan 2014 to Jan 2015, were prospective follow-up for six month.

    Results: We follow-up 958 consecutive HCWs with OEBF (76.3% women), mainly nurse technicians (325 [34%]) and nurses (187 [20%]). The most frequent place of exposure was the surgical ward (126 [13%]). Percutaneous injuries were the most common (808 [84%]) and in 433 of the cases (45%) hollow needles were involved. In 417 (44%) cases of OEBF, the fluid involved was blood. There were 73 (7.6%) positive sources: 58 (6.1%) HIV, 6 (0.6%) HBV and 9 (0.9%) HCV. Antiretroviral therapy (ART) was indicated to 67 HCWs: 63/67 (94%) zidovudine/lamiduvine; 1 tenofovir/emtricitabine and 3 received also lopinavir/r. Adverse effects to ART were present in 21/67 (31%) HCWs, mainly digestive intolerance (19 HCWs), but only 5/67 (7.4%) HCWs demanded to stop ARV. No confirmed seroconversion for HBV and HCV occurred. For HIV, 1 HCW seroconverted at 1st month's control after exposure. His accident was considered as a low risk and he did not receive prophylaxis, but he had proper risk factors for infection (MSM with untreated HIV (+) partner). Only 336 (35%) HCWs completed the 6-month follow-up. HCWs with exposure to an unknown source had lower compliance (123/402, 30.6%) than HCWs with exposure to a known source (199/519, 38%) or partially known source (14/37, 37%)(p = 0.04). In the subgroup of exposures with known source, compliance was lower in those negative for the 3 virus (181/488, 37%) than those positive for one of them (32/68, 47%), (p= 0.01).

    Conclusion: The observed adherence to the follow-up was quite low and indicates that improvement must be done in this area. It is remarkable the low adherence to follow-up among HCWs exposed to an unknown source. The suboptimal tolerance to ART supports the current trend to prefer other nucleoside analogs, such as tenofovir and emtricitabine, as 1st choice therapy in this setting.

    Ines Ceron, MD, P. Universidad Católica de Chile, Santiago, Chile and Guillermo Acuña, MD, Hospital del Trabajador de Santiago, Santiago, Chile

    Disclosures:

    I. Ceron, None

    G. Acuña, None

    Findings in the abstracts are embargoed until 12:01 a.m. CDT, Wednesday Oct. 26th with the exception of research findings presented at the IDWeek press conferences.