Exposure to blood caregivers: knowledge of HIV status of the patient appears to be improving

Knowledge of the status of the source patient vis-à-vis HIV or hepatitis C virus (HCV) would improve and contribute to better support caregivers accident victims with blood exposure (AES).
This is one of the main lessons from national surveillance of BSE in health facilities whose results are published by the Institute of Health Surveillance (VS).

These data were for the first time based on a common methodology Alert Network, investigation and surveillance of nosocomial infections (Grape), work has been carried out with the study on the exposure of Group caregivers to infectious agents (Geres).

The first national report was published on the subject but it was a collection of data for the year 2002, prior to the development of a common methodology.

AES 6316 were identified in 228 schools in four of the five centers coordinating the fight against nosocomial infections, namely C.Clin East, West, Southeast and Southwest.

The incidence of BSE found for 100 hospital beds is 7.5, against 6.9 in 2002. This allows to estimate the number of 35.364 AES were reported in 2003 occupational physicians French health establishments (32,423 in 2002).

"Although the incidence data cover a cohort of a little wider than in 2002 establishments, the frequency of AES appears to be relatively similar," the authors write in the study.

However, the results show a "tendency to improved knowledge of the status of the source patient, vis-à-vis HIV and HCV, which affects the subsequent care of the caregiver."

Have been identified that 16.9% of unknown serology for HIV in 2003 against 20.3% in 2002 and 20.6% for HCV serology unknown in 2003 against 25.6% in 2002.

"If these rates are still too high, you can see the beginning of the impact of efforts to raise awareness about it," the authors write.

The injection is the act most frequently involved and represents 19.2% of the AES and in 84.4% of cases, there is a subcutaneous injection.

If we approach the subject through the material in question, there are 547 needles subcutaneous (10% of AES with at least one material in question specified), which must be added 474 insulin pens (8.7%) and 256 pre-filled syringes of heparin (4.7% in 2003, 3.9% in 2002). For the latter, it should be noted that nearly a quarter are classified safety syringes.

AES with a rate of 41.5 per 100,000 movements, care of chambers implanted catheter remain problematic. If the evolution of the quality of materials has reduced the rebound effect at the exit of the needles, the security of these actions should be a priority, say the authors.