Infection control in dermatology practice

Department of Microbiology, Queen Mary Hospital, 102 Pokfulam Road, Pokfulam, Hong Kong Infection control is an often neglected topic until the outbreak of severe acute respiratory syndrome (SARS) in 2003, when eight healthcare workers succumbed as a result of community and nosocomial outbreaks. This alerted all healthcare workers to comply with infection control practices in both the in-patient and out-patient settings as failure to do so might be a matter of life and death. Standard and transmission-based precautions have been promoted in the hospitals since 1996 and have also been applied in the dermatology clinic in the recent years. Standard precautions should be applied in all patients with the potential to infect others through blood and body fluids and include hand hygiene, careful handling of sharps, and the appropriate use of personal protective equipments during exposure to blood, body fluids, secretions, excretions except sweat, and breached skin and mucous membranes. Transmission-based precautions are the additional measures against pathogens that are spread through contact, droplets, and air. Among all infection control measures, hand hygiene practice using waterless alcohol-based hand rub remains the cornerstone of infection control – a 3 log reduction of microbial load can be achieved after 15 seconds of hand rubbing. Since most of the common pathogens including community-associated methicillin resistant Staphylococcus aureus and influenza virus can survive on the hands for a short period of time, frequent use of alcoholbased hand rub, especially before touching the mucous membranes, can prevent self-inoculation of these pathogens. On the other hand, application of directly observed hand hygiene among patients and regular cleaning of the clinic may help to reduce the risk of environmental contamination by pathogens like Chlamydia trachomatis and Neisseria gonorrhoeae which can survive on dry inanimate surfaces for 1-3 days, and papillomavirus which can survive for up to 7 days. Review Article