OBSTETRIC AND GYNECOLOGICAL ANESTHESIA: Edited by Andreas HoeftAnesthesia in patients with infectious disease caused by multi-drug resistant bacteriaEinav, Sharona; Wiener-Well, YonitbAuthor Information aThe Surgical Intensive Care Unit bThe Infectious Disease Unit, Shaare Zedek Medical Center and the Hebrew University, Faculty of Medicine, Jerusalem, Israel Correspondence to Sharon Einav, MSc, MD, Director, the Surgical Intensive Care Unit, Shaare Zedek Medical Center and the Hebrew University, Faculty of Medicine, POB 3235, Jerusalem 91031, Israel. Tel: +972 2 6666664; e-mail: [email protected] Current Opinion in Anaesthesiology: June 2017 - Volume 30 - Issue 3 - p 426-434 doi: 10.1097/ACO.0000000000000457 Buy Metrics Abstract Purpose of review Up to 50% of specific bacterial strains in healthcare admission facilities are multi-drug resistant organisms (MDROs). Involvement of anesthesiologists in management of patients carrying/at risk of carrying MDROs may decrease transmission in the Operating Room (OR). Recent findings Anesthesiologists, their work area and tools have all been implicated in MDRO outbreaks. Causes include contamination of external ventilation circuits and noncontribution of filters to prevention, inappropriate decontamination procedures for nondisposable equipment (e.g. laryngoscopes, bronchoscopes and stethoscopes) and the anesthesia workplace (e.g. external surfaces of cart and anesthesia machine, telephones and computer keyboards) during OR cleaning and lack of training in sterile drug management. Summary Discussions regarding the management of potential MDRO carriers must include anesthesia providers to optimize infection control interventions as well as the anesthesia method, the location of surgery and recovery and the details of patient transport. Anesthesia staff must learn to identify patients at risk for MDRO infection. Antibiotic prophylaxis, although not evidence based, should adhere to known best practices. Adjuvant therapies (e.g. intranasal Mupirocin and bathing with antiseptics) should be considered. Addition of nonmanual OR cleaning methods such as ultraviolet irradiation or gaseous decontamination is encouraged. Anesthesiologists must undergo formal training in sterile drug preparation and administration. Copyright © 2017 YEAR Wolters Kluwer Health, Inc. All rights reserved.