Meeting the challenge of emerging pathogens in children with cystic fibrosis

Ms Janet Wallace1

1Children’s Health Queensland, South Brisbane, Australia

Introduction

Children with cystic fibrosis are at particular risk of colonisation or infection with pathogens due to their lung physiology. Emerging pathogens associated with deterioration in health present particular infection control challenges.  The paediatric setting poses even greater difficulties and risks due to the nature of children to interact, their need to play, socialise and attend school.

Methods

Mycobacterium abscessus infection in those with serious chronic lung disease is often associated with a decline in clinical condition. Infection can be difficult to treat, requiring long-term antibiotics.

Studies have identified transmission of this organism between patients with cystic fibrosis in the healthcare setting. M. abscessus can be present for some time before identification. Given the transmission risk, likelihood of the presence of other organisms of concern and potential adverse outcome, strategies were developed to protect all children with cystic fibrosis from transmission from others and the healthcare environment.

Results

Existing transmission based precautions models didn’t provide a suitable “fit”. A new precautions type was required. “Pink precautions” were developed. These required single room accommodation or sharing only with others who aren’t at risk or posed a risk, a surgical mask to be worn outside the patient room or clinic, enhanced cleaning and use of personal protective equipment.

Conclusion

There were challenges with introducing new terminology and additional restrictions on the children. This was addressed by an education campaign for the children, families and staff. Hurdles occurred and troubleshooting, flexibility and negotiation have helped to overcome most barriers and enhance safety.


Biography:

CNC at Queensland’s Paediatric Referral Hospital and Children’s Health QLD. Worked in infection management and related fields in NSW and QLD for over 20 years. Graduate Diploma in Infection Control (1997) and currently undertaking Masters of Public Health. Completing a dissertation to investigate the potential to clear paediatric patients of multi-resistant organisms. Interested in innovation, quality improvement and research which can translate into practice.