Infection control in the intensive care unit: expert consensus statements for SARS-CoV-2 using a Delphi method

Prashant Nasa; Elie Azoulay; Arunaloke Chakrabarti; Jigeeshu V. Divatia; Ravi Jain; Camilla Rodrigues; Victor D. Rosenthal; Waleed Alhazzani; Yaseen M. Arabi; Jan Bakker; Matteo Bassetti; Jan De Waele; George Dimopoulos; Bin Du; Sharon Einav; Laura Evans; Simon Finfer; Claude Guérin; Naomi E. Hammond; Samir Jaber; Ruth M. Kleinpell; Younsuck Koh; Marin Kollef; Mitchell M. Levy; Flavia R. Machado; Jordi Mancebo; Ignacio Martin-Loeches; Mervyn Mer; Michael S. Niederman; Paolo Pelosi; Anders Perner; John V. Peter; Jason Phua; Lise Piquilloud; Mathias W. Pletz; Andrew Rhodes; Marcus J. Schultz; Mervyn Singer; Jéan François Timsit; Balasubramanian Venkatesh; Jean Louis Vincent; Tobias Welte; Sheila N. Myatra

doi:https://doi.org/10.1016/S1473-3099(21)00626-5

Infection control in the intensive care unit: expert consensus statements for SARS-CoV-2 using a Delphi method

Prashant Nasa, Elie Azoulay, Arunaloke Chakrabarti, Jigeeshu V. Divatia, Ravi Jain, Camilla Rodrigues, Victor D. Rosenthal, Waleed Alhazzani, Yaseen M. Arabi, Jan Bakker, Matteo Bassetti, Jan De Waele, George Dimopoulos, Bin Du, Sharon Einav, Laura Evans, Simon Finfer, Claude Guérin, Naomi E. Hammond, Samir JaberRuth M. Kleinpell, Younsuck Koh, Marin Kollef, Mitchell M. Levy, Flavia R. Machado, Jordi Mancebo, Ignacio Martin-Loeches, Mervyn Mer, Michael S. Niederman, Paolo Pelosi, Anders Perner, John V. Peter, Jason Phua, Lise Piquilloud, Mathias W. Pletz, Andrew Rhodes, Marcus J. Schultz, Mervyn Singer, Jéan François Timsit, Balasubramanian Venkatesh, Jean Louis Vincent, Tobias Welte, Sheila N. Myatra

Research output: Contribution to journal › Review article › Academic › peer-review

9 Citations (Scopus)

Abstract

During the current COVID-19 pandemic, health-care workers and uninfected patients in intensive care units (ICUs) are at risk of being infected with SARS-CoV-2 as a result of transmission from infected patients and health-care workers. In the absence of high-quality evidence on the transmission of SARS-CoV-2, clinical practice of infection control and prevention in ICUs varies widely. Using a Delphi process, international experts in intensive care, infectious diseases, and infection control developed consensus statements on infection control for SARS-CoV-2 in an ICU. Consensus was achieved for 31 (94%) of 33 statements, from which 25 clinical practice statements were issued. These statements include guidance on ICU design and engineering, health-care worker safety, visiting policy, personal protective equipment, patients and procedures, disinfection, and sterilisation. Consensus was not reached on optimal return to work criteria for health-care workers who were infected with SARS-CoV-2 or the acceptable disinfection strategy for heat-sensitive instruments used for airway management of patients with SARS-CoV-2 infection. Well designed studies are needed to assess the effects of these practice statements and address the remaining uncertainties.

Original language	English
Pages (from-to)	e74-e87
Journal	The Lancet Infectious Diseases
Volume	22
Issue number	3
DOIs	https://doi.org/10.1016/S1473-3099(21)00626-5
Publication status	Published - Mar 2022

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Nasa, P., Azoulay, E., Chakrabarti, A., Divatia, J. V., Jain, R., Rodrigues, C., Rosenthal, V. D., Alhazzani, W., Arabi, Y. M., Bakker, J., Bassetti, M., De Waele, J., Dimopoulos, G., Du, B., Einav, S., Evans, L., Finfer, S., Guérin, C., Hammond, N. E., ... Myatra, S. N. (2022). Infection control in the intensive care unit: expert consensus statements for SARS-CoV-2 using a Delphi method. The Lancet Infectious Diseases, 22(3), e74-e87. https://doi.org/10.1016/S1473-3099(21)00626-5

@article{391696e3522e47349a35f6266e4191b7,

title = "Infection control in the intensive care unit: expert consensus statements for SARS-CoV-2 using a Delphi method",

abstract = "During the current COVID-19 pandemic, health-care workers and uninfected patients in intensive care units (ICUs) are at risk of being infected with SARS-CoV-2 as a result of transmission from infected patients and health-care workers. In the absence of high-quality evidence on the transmission of SARS-CoV-2, clinical practice of infection control and prevention in ICUs varies widely. Using a Delphi process, international experts in intensive care, infectious diseases, and infection control developed consensus statements on infection control for SARS-CoV-2 in an ICU. Consensus was achieved for 31 (94%) of 33 statements, from which 25 clinical practice statements were issued. These statements include guidance on ICU design and engineering, health-care worker safety, visiting policy, personal protective equipment, patients and procedures, disinfection, and sterilisation. Consensus was not reached on optimal return to work criteria for health-care workers who were infected with SARS-CoV-2 or the acceptable disinfection strategy for heat-sensitive instruments used for airway management of patients with SARS-CoV-2 infection. Well designed studies are needed to assess the effects of these practice statements and address the remaining uncertainties.",

author = "Prashant Nasa and Elie Azoulay and Arunaloke Chakrabarti and Divatia, {Jigeeshu V.} and Ravi Jain and Camilla Rodrigues and Rosenthal, {Victor D.} and Waleed Alhazzani and Arabi, {Yaseen M.} and Jan Bakker and Matteo Bassetti and {De Waele}, Jan and George Dimopoulos and Bin Du and Sharon Einav and Laura Evans and Simon Finfer and Claude Gu{\'e}rin and Hammond, {Naomi E.} and Samir Jaber and Kleinpell, {Ruth M.} and Younsuck Koh and Marin Kollef and Levy, {Mitchell M.} and Machado, {Flavia R.} and Jordi Mancebo and Ignacio Martin-Loeches and Mervyn Mer and Niederman, {Michael S.} and Paolo Pelosi and Anders Perner and Peter, {John V.} and Jason Phua and Lise Piquilloud and Pletz, {Mathias W.} and Andrew Rhodes and Schultz, {Marcus J.} and Mervyn Singer and Timsit, {J{\'e}an Fran{\c c}ois} and Balasubramanian Venkatesh and Vincent, {Jean Louis} and Tobias Welte and Myatra, {Sheila N.}",

note = "Funding Information: PN reports honoraria for lectures and other educational events from Tabuk Pharmaceuticals, and is a member of Edward Lifesciences Advisory Board Panel, outside of the submitted work. JVD reports personal fees (paid to institution) from Edwards India, outside the submitted work. MB reports honoraria for lectures and another educational event from Angelini, Bayer, bioM{\'e}rieux, Cipla, Gilead Sciences, Menarini, Merck Sharp & Dohme (MSD), Pfizer, and Shionogi; grants from Pfizer and MSD, outside of the submitted work; and is on the advisory board of Cidara Therapeutics. JDW reports honoraria (paid to institution) for lectures and other educational events from MSD and Pfizer, outside of the submitted work. BD reports research grants from Ministry of Science and Technology, People's Republic of China (research grant 2020YFC0841300), and Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences (2020-I2M-2-005 and 2019-I2M-1-001), outside of the submitted work. LE reports consulting fees (paid to institution) for the National Emerging Special Pathogen Training and Education Centre, outside of the submitted work. SJ reports academic consultation fees from Drager, Fisher-Paykel, Medtronic, Baxter International, and Fresenius–Xenios; and honoraria for lectures and other educational events from Fisher-Paykel and Baxter, outside of the submitted work. MK reports honoraria from Merck and Pfizer for lectures and other educational events, outside of the submitted work. JM reports research grants (paid to institution) from Covidien (Medtronic) and Canadian Institutes of Health Research; personal consultation fees from Janssen Pharmaceuticals and Faron Pharmaceuticals; honoraria from Medtronic for lectures and other educational events; and a consulting agreement signed with Vyaire, outside of the submitted work. MSN reports personal consulting fees from Abbvie, outside of the submitted work. AP reports research grants from Novo Nordisk Foundation, Pfizer, and Fresenius Kabi, outside of the submitted work. MS reports research grants and advisory board fees from NewB; research grants from DSTL, Critical Pressure, and Apollo Therapeutics; speaking fees (paid to institution) from Amormed, advisory board fees from Biotest, GE, Baxter, Roche, and Bayer; and honoria from Shionogi, outside of the submitted work. BV reports research grants and honoraria for the guest lecture and other educational events from Baxter, outside of the submitted work. All other authors declare no competing interests. Publisher Copyright: {\textcopyright} 2022 Elsevier Ltd",

year = "2022",

month = mar,

doi = "https://doi.org/10.1016/S1473-3099(21)00626-5",

language = "English",

volume = "22",

pages = "e74--e87",

journal = "The Lancet Infectious Diseases",

issn = "1473-3099",

publisher = "Lancet Publishing Group",

number = "3",

}

Nasa, P, Azoulay, E, Chakrabarti, A, Divatia, JV, Jain, R, Rodrigues, C, Rosenthal, VD, Alhazzani, W, Arabi, YM, Bakker, J, Bassetti, M, De Waele, J, Dimopoulos, G, Du, B, Einav, S, Evans, L, Finfer, S, Guérin, C, Hammond, NE, Jaber, S, Kleinpell, RM, Koh, Y, Kollef, M, Levy, MM, Machado, FR, Mancebo, J, Martin-Loeches, I, Mer, M, Niederman, MS, Pelosi, P, Perner, A, Peter, JV, Phua, J, Piquilloud, L, Pletz, MW, Rhodes, A, Schultz, MJ, Singer, M, Timsit, JF, Venkatesh, B, Vincent, JL, Welte, T & Myatra, SN 2022, 'Infection control in the intensive care unit: expert consensus statements for SARS-CoV-2 using a Delphi method', The Lancet Infectious Diseases, vol. 22, no. 3, pp. e74-e87. https://doi.org/10.1016/S1473-3099(21)00626-5

TY - JOUR

T1 - Infection control in the intensive care unit

T2 - expert consensus statements for SARS-CoV-2 using a Delphi method

AU - Nasa, Prashant

AU - Azoulay, Elie

AU - Chakrabarti, Arunaloke

AU - Divatia, Jigeeshu V.

AU - Jain, Ravi

AU - Rodrigues, Camilla

AU - Rosenthal, Victor D.

AU - Alhazzani, Waleed

AU - Arabi, Yaseen M.

AU - Bakker, Jan

AU - Bassetti, Matteo

AU - De Waele, Jan

AU - Dimopoulos, George

AU - Du, Bin

AU - Einav, Sharon

AU - Evans, Laura

AU - Finfer, Simon

AU - Guérin, Claude

AU - Hammond, Naomi E.

AU - Jaber, Samir

AU - Kleinpell, Ruth M.

AU - Koh, Younsuck

AU - Kollef, Marin

AU - Levy, Mitchell M.

AU - Machado, Flavia R.

AU - Mancebo, Jordi

AU - Martin-Loeches, Ignacio

AU - Mer, Mervyn

AU - Niederman, Michael S.

AU - Pelosi, Paolo

AU - Perner, Anders

AU - Peter, John V.

AU - Phua, Jason

AU - Piquilloud, Lise

AU - Pletz, Mathias W.

AU - Rhodes, Andrew

AU - Schultz, Marcus J.

AU - Singer, Mervyn

AU - Timsit, Jéan François

AU - Venkatesh, Balasubramanian

AU - Vincent, Jean Louis

AU - Welte, Tobias

AU - Myatra, Sheila N.

N1 - Funding Information: PN reports honoraria for lectures and other educational events from Tabuk Pharmaceuticals, and is a member of Edward Lifesciences Advisory Board Panel, outside of the submitted work. JVD reports personal fees (paid to institution) from Edwards India, outside the submitted work. MB reports honoraria for lectures and another educational event from Angelini, Bayer, bioMérieux, Cipla, Gilead Sciences, Menarini, Merck Sharp & Dohme (MSD), Pfizer, and Shionogi; grants from Pfizer and MSD, outside of the submitted work; and is on the advisory board of Cidara Therapeutics. JDW reports honoraria (paid to institution) for lectures and other educational events from MSD and Pfizer, outside of the submitted work. BD reports research grants from Ministry of Science and Technology, People's Republic of China (research grant 2020YFC0841300), and Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences (2020-I2M-2-005 and 2019-I2M-1-001), outside of the submitted work. LE reports consulting fees (paid to institution) for the National Emerging Special Pathogen Training and Education Centre, outside of the submitted work. SJ reports academic consultation fees from Drager, Fisher-Paykel, Medtronic, Baxter International, and Fresenius–Xenios; and honoraria for lectures and other educational events from Fisher-Paykel and Baxter, outside of the submitted work. MK reports honoraria from Merck and Pfizer for lectures and other educational events, outside of the submitted work. JM reports research grants (paid to institution) from Covidien (Medtronic) and Canadian Institutes of Health Research; personal consultation fees from Janssen Pharmaceuticals and Faron Pharmaceuticals; honoraria from Medtronic for lectures and other educational events; and a consulting agreement signed with Vyaire, outside of the submitted work. MSN reports personal consulting fees from Abbvie, outside of the submitted work. AP reports research grants from Novo Nordisk Foundation, Pfizer, and Fresenius Kabi, outside of the submitted work. MS reports research grants and advisory board fees from NewB; research grants from DSTL, Critical Pressure, and Apollo Therapeutics; speaking fees (paid to institution) from Amormed, advisory board fees from Biotest, GE, Baxter, Roche, and Bayer; and honoria from Shionogi, outside of the submitted work. BV reports research grants and honoraria for the guest lecture and other educational events from Baxter, outside of the submitted work. All other authors declare no competing interests. Publisher Copyright: © 2022 Elsevier Ltd

PY - 2022/3

Y1 - 2022/3

N2 - During the current COVID-19 pandemic, health-care workers and uninfected patients in intensive care units (ICUs) are at risk of being infected with SARS-CoV-2 as a result of transmission from infected patients and health-care workers. In the absence of high-quality evidence on the transmission of SARS-CoV-2, clinical practice of infection control and prevention in ICUs varies widely. Using a Delphi process, international experts in intensive care, infectious diseases, and infection control developed consensus statements on infection control for SARS-CoV-2 in an ICU. Consensus was achieved for 31 (94%) of 33 statements, from which 25 clinical practice statements were issued. These statements include guidance on ICU design and engineering, health-care worker safety, visiting policy, personal protective equipment, patients and procedures, disinfection, and sterilisation. Consensus was not reached on optimal return to work criteria for health-care workers who were infected with SARS-CoV-2 or the acceptable disinfection strategy for heat-sensitive instruments used for airway management of patients with SARS-CoV-2 infection. Well designed studies are needed to assess the effects of these practice statements and address the remaining uncertainties.

AB - During the current COVID-19 pandemic, health-care workers and uninfected patients in intensive care units (ICUs) are at risk of being infected with SARS-CoV-2 as a result of transmission from infected patients and health-care workers. In the absence of high-quality evidence on the transmission of SARS-CoV-2, clinical practice of infection control and prevention in ICUs varies widely. Using a Delphi process, international experts in intensive care, infectious diseases, and infection control developed consensus statements on infection control for SARS-CoV-2 in an ICU. Consensus was achieved for 31 (94%) of 33 statements, from which 25 clinical practice statements were issued. These statements include guidance on ICU design and engineering, health-care worker safety, visiting policy, personal protective equipment, patients and procedures, disinfection, and sterilisation. Consensus was not reached on optimal return to work criteria for health-care workers who were infected with SARS-CoV-2 or the acceptable disinfection strategy for heat-sensitive instruments used for airway management of patients with SARS-CoV-2 infection. Well designed studies are needed to assess the effects of these practice statements and address the remaining uncertainties.

UR - http://www.scopus.com/inward/record.url?scp=85124997973&partnerID=8YFLogxK

U2 - https://doi.org/10.1016/S1473-3099(21)00626-5

DO - https://doi.org/10.1016/S1473-3099(21)00626-5

M3 - Review article

C2 - 34774188

SN - 1473-3099

VL - 22

SP - e74-e87

JO - The Lancet Infectious Diseases

JF - The Lancet Infectious Diseases

IS - 3

ER -

Infection control in the intensive care unit: expert consensus statements for SARS-CoV-2 using a Delphi method

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