Sharps-related infections

We have previously discussed the wide diversity of infections that can be transmitted by sharps or needlestick injury.

Though the risk may be small, the focus remains on just two or three bloodborne virus agents, Hepatitis B and HIV, and possibly Hepatitis C. All three are important, with perhaps Hep C the most likely though lack of recognition of this widespread pathogen results in its exclusion from some texts.

But the reality is that almost any infection can be transmitted after needlestick injury. Virus infection, bacterial infection, parasitic infection and many others have been recorded. To that list we can now add infection with Trichophyton verrucosum, a complex dermatophyte fungus that causes ringworm infection in cattle and occasionally in sheep, horses and humans.

Infection occurred in a vet who injured herself while injecting ringworm vaccine LTF 130 into a calf who kicked back resulting in a needlestick to her abdomen.

Seyfarth F et al.Trichophyton verrucosum infection after needlestick injury with an attenuated live vaccine against cattle ringworm. Mycoses 2011 DOI: 10.1111/j.1439-0507.2011.02015.x

Sharps injury must never be underestimated. They can be caused by a hypodermic needle or any other item sufficiently sharps to break skin. An additional and equally significant risk results from blood and bloodstained bloody fluid exposure with splashes to the mouth or eyes, or contamination of pre-existing cuts and grazes, open eczema or psoriasis etc.

Many of these exposures occur almost without a second thought. Under-reporting is likely and the infections that may ensue are not linked to exposure unless severe and life-threatening. This is cause for considerable concern, as safety precautions and the regulation of all biohazardous wastes including clinical and sanitary wastes is buoyed by the lack of evidence for Hep B, Hep C or HIV infection. That is unsafe and dismissal or downgrading of potential risks in the absence of documented evidence for infection among waste handlers is not appropriate.


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