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Infection control

The primary purpose of infection control measures in the management of CF is to prevent airway infection spreading from one patient with CF to another. A secondary consideration to protect children with CF from other respiratory infections that may be transmitted from individuals without CF. Our policy on infection control can be viewed as a pdf document - click here. All health professionals (including on call staff and ward nursing staff) working in OCCFN should be familiar with this document.

High-risk infections

When a child is known to have airway infection with non-tuberculous mycobacteria (particularly Mycobacterium abscessus), Burkholderia cepacia complex (BCC), MRSA or epidemic forms of Pseudomonas aeruginosa, particular care is required. The necessary precautions are described in the policy and re-iterated here.

Outpatient visits

Children with high-risk infections should be seen at the end of CF clinic (or at a non-CF clinic) so that no further children with CF use that room on that day. Particular care should be used to clean down all surfaces. For children with Mycobacterium abscessus, the sporicidal Clinel wipes should be used.

Inpatient stays

There must be strict segregation during inpatient stays. All children with Mycobacterium abscessus must be in a cubicle. In addition, they must either be the only child with CF on that ward, or they must be in a room with ensuite toilet and bathroom.

The following guidance should be followed:

• All staff must wear aprons and gloves when entering the room.
• All staff must wash their hands with soap and water after direct patient contact.
• All physiotherapy must take place in the patient's room.
• Exercise must either take place in the patient's room or if the gym is used, no further children with CF should use the gym that day, and all surfaces should be cleaned.
• Patients must wash their hands with soap and water before using the spirometer or any other hand-held devices. As per standard guidance for spirometer use, microbiological filters should be used and patients should not inhale through the spirometer.

Children with high risk infections are not a risk to other children (other than those with significant immune suppression) and so are not restricted in their access to the play areas, hospital school, or other facilities provided there are no other children with CF who will be using those facilities on the same day and those areas area cleaned in the usual way at the end of the day.