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Infection Control for children and young people with CF

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Infection Control practices for children and young people with Cystic Fibrosis

You can read more about the background of this project, purpose of the recommendations or the methodology here.

Key Points

  • Healthcare personnel should assume that all people with Cystic Fibrosis (CF) could have respiratory pathogens that are transmissible to other people with CF.
  • Children and Young people with CF, who are inpatients, should be admitted to single rooms, and should not share a nurse with another patient with CF.
  • All people with CF should avoid close contact with other people with CF in all settings unless they are immediate family/whanau.
  • All clinics should implement a locally agreed infection control policy for Children and Young people with CF.

All people with CF should wear a surgical mask (or mask as per local hospital policy) when in the hospital setting to reduce the risk of transmission or acquisition of CF pathogens. Masks should be worn throughout the facility, including in the toilets/restrooms. Masks should not be worn during lung function testing, in the clinic exam room, or in the patient's hospital room. (Young children, especially under the age of three, may not tolerate wearing a mask, however they should be gently familiarised with the mask and encouraged to wear it as they become used to it).

NB: These guidelines recommend that surgical masks be used to stop cross infection in healthcare settings by children and young people with CF. Surgical masks are designed to prevent the release of potential contaminates from the user into their immediate environment. Surgical N95 masks, will in addition, help reduce wearer exposure to certain airborne biological particles. However, if the N95 mask is not correctly fitted or becomes contaminated through incorrect use they offer no benefits over the surgical mask. Environmental masks (such as Vogmask) are products designed to prevent inhaled contaminants. They are not designed to prevent germs from being exhaled and are therefore not recommended to prevent cross-infection in CF healthcare settings

All people with CF regardless of their respiratory tract culture results, should be separated by a least 2 metres from other people with CF in all settings, to reduce the risk of droplet transmission of CF pathogens. This does not apply to members of the same household.

All people with CF and their family/whanau/friends perform hand hygiene (with either alcohol-based hand rub or antimicrobial soap and water) when there is potential for contamination of hands with pathogens, such as the following:

Other practices by children and young people with Cystic Fibrosis (CF) including hygiene/leisure/day-care and school


All people with CF should follow Respiratory Hygiene practices to contain their secretions when coughing (i.e. cough into a tissue, immediately discard soiled tissue into a trash receptacle, and perform hand hygiene after disposing of soiled tissue). A covered rubbish bin with a foot pedal is preferred.

It is recommended that all people with CF who do not live in the same house, should avoid activities and risk factors that are associated with transmission of CF pathogens in all settings including:

Activities that all people with CF, including those who live in the same household, should avoid include the following:

It is recommended that people with CF should limit prolonged and/or repeated exposure to activities that generate dust from soil and organic matter (e.g. gardening and lawn mowing) to decrease exposure to potential soil borne pathogens (e.g. Burkholderia spp. and Aspergillus spp.).

It is recommended that people with CF should avoid exposure to construction and renovation activities that generate dust to decrease exposure to potential pathogens (e.g. Aspergillus spp.).

It is recommended that people with CF avoid activities in hot tubs, whirlpool spas, and stagnant water. Swimming pools with adequate chlorination are considered safe, however it is recommended to avoid the changing rooms as these are often warm, moist environments in which bacteria/fungi thrive.

It is recommended that people with CF avoid cleaning stalls, pens, cages or coops of animals to decrease the exposure to potential pathogens (e.g. Aspergillus spp.).

It is recommended that people with CF attending the same day care and/or school should not be in the same room at the same time unless they live in the same household. Strategies should be developed to minimise contact between people with CF (e.g. assignment to separate classrooms and separation during other scheduled common activities, including lunch, physical education and playtimes).

References

  1. Cystic Fibrosis, Australia (2012).  Infection Control Guidelines for Cystic Fibrosis Patients and Carers.  Available from: http://www.cysticfibrosis.org.au/media/wysiwyg/CFAustralia/PDF_files/02_CFA_InfectionControlGuidelines_LowRez.pdf
  2. Cystic Fibrosis Foundation Guideline (2014).  Infection Prevention and Control Guideline for Cystic Fibrosis: 2013 Update.  Available from: http://www.jstor.org/stable/10.1086/676882?origin=JSTOR-pdf
  3. Royal Brompton & Harefield, NHS Foundation Trust (2014).  Clinical Guidelines: Care of Children with Cystic Fibrosis. Available from: www.rbht.nhs.uk/childrencf

Information last reviewed: October 2016

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