The importance of infection control and prevention in anesthesiology
Keywords:
Patient safety, Anesthesiology, Communicable diseases, Anesthesia, Colombia
Abstract
The key role of the field of infectious diseases in other medical specialties, including anesthesiology, is currently well known. The anesthesiologist faces a potential risk of con tributing to the development of healthcare associated infections in the operating rooms; however, the infectious complications derived from anesthesia have been underestimated. It is important to acknowledge that there are some deficiencies in research, notification, and publication of reports on anesthesia-associated infectious events in developing countries, particularly in Colombia, which is the focus of our attention in this article. As far as we know, only five countries 一 most of them developed 一 have carried out studies on the practices and knowledge of the anesthesiology personnel with regards to universal recommendations for the prevention and control of anesthesia-associated infections. This document discusses the importance of infections in the area of anesthesiology and at present in Colombia. Fur thermore, the need to comply with basic infection prevention and control precautions and of creating awareness of safe injection practices is recognized.
References
1. Villalobos A, Barrero L, Rivera S, Ovalle M, Valera D. Vigilancia de infecciones asociadas a la atención en salud, resistencia bacteriana y consumo de antibióticos en hospitales de alta complejidad, Colombia, 2011. Biomédica Rev del Inst Nac Salud. 2014;34:67-80.
2. World Health Organization. Report on the Burden of Endemic Health Care-Associated Infection Worldwide; 2011. Available from: http://apps.who.int/iris/bitstream/10665/80135/1/ 9789241501507_eng.pdf WHO Libr Cat Data. 2011;40 [cited in: October 20/2015].
3. Kishi D, Videira R. Description of nosocomia infection prevention practices by anesthesiologists in a university hospital. Rev Bras Anestesiol. 2011;61:177-81.
4. Perz JF, Thompson ND, Schaefer MK, Patel PR. US outbreak investigations highlight the need for safe injection practices and basic infection control. Clin Liver Dis. 2010;14:137-51.
5. Munoz-Price LS, Birnbach DJ. Hand hygiene and anesthesiology. Int Anesthesiol Clin. 2013;51:79-92.
6. Woodbury A, Knight K, Fry L, Margolias G, Lynde GC. A survey of anesthesiologist and anesthetist attitudes toward single-use vials in an academic medical center. J Clin Anesth. 2014;26:125-30.
7. Du Moulin GC, Hedley-Whyte J. Hospital-associated viral infection and the anesthesiologist. Anesthesiology. 1983;59:51-65.
8. Browne R, Chernesky M. Infectious diseases and the anaesthetist. Can J Anaesth. 1988;35:655-65.
9. Zorrilla-Vaca A, Escandón-Vargas K. Bacteriostatic effect of mixtures of1%propofol with 4%lidocaine versus 4% lidocaine alone: regards on microbiologic studies in the field of anesthesiology. Infect Control Hosp Epidemiol. 2014;44:747-9.
10. Ross RS, Viazov S, Gross T, Hofmann F, Seipp H-M, Roggendorf M. Transmission of hepatitis C virus from a patient to an anesthesiology assistant to five patients. N EnglJ Med. 2000;343:1851-4.
11. Tait A, Tuttle D. Preventing perioperative transmission of infection: a survey of anesthesiology practice. Anesth Analg. 1995;80:764-9.
12. El Mikatti N, Dillon P, Healy TE. Hygienic practices of consultant anaesthetists: a survey in the north-west region of the UK. Anaesthesia. 1999;54:13-8.
13. Loftus RW, Koff MD, Birnbach DJ. The dynamics and implications of bacterial transmission events arising from the anesthesia work area. Anesth Analg. 2015;120:853-60.
14. Parlow J. Blood contamination of drug syringes used in anaesthesia. Can J Anaesth. 1989;36:S61-2.
15. Trépanier CA, Lessard MR, Brochu JG, Denault PH. Risk of cross-infection related to the multiple use of disposable syringes. Can J Anaesth. 1990;37:156-9.
16. Blogg CE, Ramsay MA, Jarvis JD. Infection hazard from syringes. Br J Anaesth. 1974;46:260-2.
17. Koepk JW, Reller LB, Masters HA, Selner JC. Viral contamination of intradermal skin test syringes. Ann Allergy. 1985;55:776-8.
18. Lutz CT, Bell CE, Wedner HJ, Krogstad DJ. Allergy testing of multiple patients should no longer be performed with a common syringe. N Engl J Med. 1984;310:1335-7.
19. Ford K. Survey of syringe and needle safety among student registered nurse anesthetists: are we making any progress? AANA J. 2013;81:37-42.
20. Asai T, Matsumoto S, Shingu K, Harmer M. Incidence of blood-borne infectious micro-organisms: would you still not wear gloves? Anaesthesia. 2000;55:591-2.
21. Olds JW, Kisch AL, Eberle BJ, Wilson JN. Pseudomonas aeruginosa respiratory tract infection acquired from a contaminated anesthesia machine. Am Rev Respir Dis. 1972;105:628-32.
22. Postsurgical infections associated with an extrinsically contaminated intravenous anesthetic agent?California, Illinois, Maine, and Michigan, 1990. MMWR Morb Mortal Wkly Rep. 1990;39:426-7.
23. Bennett SN, McNeil MM, Bland La, Arduino MJ, Villarino ME, Perrotta DM, et al. Postoperative infections traced to contamination of an intravenous anesthetic, propofol. N EnglJ Med. 1995;333:147-54.
24. Kidd-Ljunggren K, Broman E, Ekvall H, Gustavsson O. Nosocomial transmission of hepatitis B virus infection through multiple-dose vials. J Hosp Infect. 1999;43:57-62.
25. Tallis G, Ryan G, Lambert S, Bowden D, McCaw R, Birch C, et al. Evidence of patient-to-patient transmissio of hepatitis C virus through contaminated intravenous anaesthetic ampoules. J Viral Hepat. 2003;10:234-9.
26. Centers for Disease Control and Prevention (CDC). Invasive Staphylococcus aureus infections associated with pain injections and reuse of single-dose vials - Arizona and Delaware, 2012. Morb Mortal Wkly Rep. 2012;61:5014.
27. Alter MJ, Ahtone J, Maynard JE. Hepatitis B virus transmission associated with a multiple-dose vial in a hemodialysis unit. Ann Intern Med. 1983;99:330-3.
28. Comstock RD, Mallonee S, Fox JL, Moolenaar RL, Vogt TM, Perz JF, et al. A large nosocomial outbreak of hepatitis C and hepatitis B among patients receiving pain remediation treatments. Infect Control Hosp Epidemiol. 2004;25:576-83.
29. Chant K, Kociuba K, Munro R, Crone S, Kerridge R, Quin J, et al. Investigation of possible patient-to-patient transmission of hepatitis C in a hospital. NSW Public Heal Bull. 1994;5:47-51.
30. Fischer G, Schaefe M, Labus B, Sands L, Rowley P, Azzam I, et al. Hepatitis C virus infections from unsafe injection practices at an endoscopy clinic in Las Vegas, Nevada, 2007-2008. Clin Infect Dis. 2010;51:267-73.
31. Yu H, Tang G, Liaw W, Yien H, Lee T. Pseudomonas cepacia induced septic shock after propofol - a case report. Acta Anaesthesiol Sin. 2000;38:53-6.
32. Massari M, Petrosillo N, Ippolito G, Solforosi L, Bonazzi L, Clementi M. Transmission of hepatitis C virus in a gynecological surgery setting. J Clin Microbiol. 2001;39:2860-3.
33. Centers for Disease Control and Prevention. Transmission of hepatitis B and C viruses in outpatient settings - New York, Oklahoma, and Nebraska, 2000-2002. MMWR Morb Mortal Wkly Rep. 2003;52:901-6.
34. Pugliese G, Gosnell C, Bartley JM, Robinson S. Injection practices among clinicians in United States health care settings. Am J Infect Control. 2010;38:789-98.
35. Hemingway CJ, Malhotra S, Almeida M, Azadian B, Yentis SM. The effect of alcohol swabs and filter straws on reducing contamination of glass ampoules used for neuroaxial injections. Anaesthesia. 2007;62:286-8.
36. Zorrilla-Vaca A, Arevalo J, Escandón-Vargas K, Soltanifar D, Mirski M. Infectious diseases risk and propofol anesthesia, 1989-2015. Emerg Infect Dis. 2015;22:981-92.
37. Zorrilla-Vaca A, Grant M, Mathur V, Li J, Wu C. The impact of neuraxial versus general anesthesia on the incidence of postoperative surgical site infections following knee or hip arthroplasty: a meta-analysis. Reg Anesth Pain Med. 2016;41:555-63.
38. Harrison CA, Rogers DW, Rosen M. Blood contamination of anaesthetic and related staff [see comments]. Anaesthesia. 1990;45:831-3.
39. O’DonnellNG, Asbury AJ. The occupational hazard of human immunodeficiency virus and hepatitis B virus infection. I. Perceived risks and preventive measures adopted by anaesthetists: a postal survey. Anaesthesia. 1992;47:923-8.
40. Rosenberg AD, Bernstein DB, Bernstei RL, Skovron ML, Ramanathan S, Turndorf H. Accidental needlesticks: do anesthesiologists practice proper infection control precautions? Am J Anesthesiol. 1995;22:125-32.
41. McNamara JT, Stacey SG, McCluskey A. Poor anaesthetist hygienic practices - a problem across all grades of anaesthetist. Anaesthesia. 1999;54:718-9.
42. Ryan AJ, Webster CS, Merry AF, Grieve DJ. A national survey of infection control practice by New Zealand anaesthetists. Anaesth Intensive Care. 2006;34:68-74.
43. Carbonne A, Veber B, Hajjar J, Zaro-Goni D, Maugat S, Seguier JC, et al. Evaluation of practices involving a cross infection risk in anaesthesia. Ann Fr Anesth Reanim. 2006;25:1158-64.
44. King C, Ogg M. Safe injection practices for administration of propofol. AORN. 2012;95:365-72.
45. Gounder P, Beers R, Bornschlegel, Katherine Hinterland K, Balter S. Medication injection safety knowledge and practices among anesthesiologists: New York State, 2011. JClin Anesth. 2013;25:521-8.
46. Fernandez PG, Loftus RW, Dodds TM, KoffMD, Reddy S, Heard SO, et al. Hand hygiene knowledge and perceptions among anesthesia providers. Anesth Analg. 2015;120:837-43.
47. Hajjar J, Girard R. Surveillance of nosocomial infections related to anesthesia. A multicenter study. Ann Fr Anesth Reanim. 2000;19:47-53.
48. Zorrilla-Vaca A, Escandón-Vargas K, Brand-Giraldo V, León T, Herrera M, Payán A. Bacterial contamination of propofol vials used in operating rooms of a third-level hospital. Am J Infect Control. 2016;44:e1-3.
49. Zorrilla-Vaca A, Ariza F, León T. Practicas de manipulación del propofol: resultados de un estudio colombiano de corte transversal. Rev Colomb Anestesiol. 2017;45:300-9.
50. ASA Committee On Occupational Health Task Force On Infection Control. Recommendations for Infection Control for the Practice of Anesthesiology. Available from: https://asahq.org/~/media/sites/asahq/files/public/resources/ asa%20committees/recommendations-for-infection-control-for-the-practice-of-anesthesiology-(1).pdf?la=en [cited in:October 20/2015].
51. Association of Anaesthetists of Great Britain and Ireland. Infection control in anaesthesia. Anaesthesia.2008;63:1027-36.
52. Merchant R, Chartrand D, Dain S, Dobson G, Kurrek MM, Lagacé A, et al. Guidelines to the practice of anesthesia -revised edition 2015. Can JAnaesth. 2015;62:54-67.
53. Australian, New Zealand College of Anaesthetists (ANZCA), Australian and New Zealand College of Anaesthetists (ANZCA) guidelines on infection control in anaesthesia. Available from: http://www.anzca.edu.au/documents/ ps28-2015-guidelines-on-infection-control-in-anaes.pdf [cited in: October 20/2015].
54. De Miguel Guijarro A. Recomendaciones para el control de la infeccion en la practica de la anestesia. Rev Esp Anestesiol Reanim. 2013;60 Suppl. 1:86-93.
55. The Hong Kong College of Anaesthesiologists. Guidelines on infection control in anaesthesia; 2015. Available from: https://www.hkca.edu.hk/ANS/standard_publications/guidep15.pdf[cited in: October 20/2015].
56. SASA guidelines for infection control in anaesthesia in South Africa 2014. South Afr Anaesth Analg. 2014;20:S1-39.
57. Rincón Valenzuela DA, Escobar B. Manual de práctica clínica basado en la evidencia: preparación del paciente para el acto quirúrgico y traslado al quirófano. Rev Colomb Anestesiol. 2015;43:32-50.
58. One needle, one syringe, only ONE time. Healthcare coalition launches new training video. AANA NewsBull. 2010;64:17.
59. Siegel JD, Rhinehart E, Jackson M, Chiarello L. 2007 Guideline for isolation precautions: preventing transmission of infectious agents in health care settings. Am J Infect Control. 2007;35:S65-164.
2. World Health Organization. Report on the Burden of Endemic Health Care-Associated Infection Worldwide; 2011. Available from: http://apps.who.int/iris/bitstream/10665/80135/1/ 9789241501507_eng.pdf WHO Libr Cat Data. 2011;40 [cited in: October 20/2015].
3. Kishi D, Videira R. Description of nosocomia infection prevention practices by anesthesiologists in a university hospital. Rev Bras Anestesiol. 2011;61:177-81.
4. Perz JF, Thompson ND, Schaefer MK, Patel PR. US outbreak investigations highlight the need for safe injection practices and basic infection control. Clin Liver Dis. 2010;14:137-51.
5. Munoz-Price LS, Birnbach DJ. Hand hygiene and anesthesiology. Int Anesthesiol Clin. 2013;51:79-92.
6. Woodbury A, Knight K, Fry L, Margolias G, Lynde GC. A survey of anesthesiologist and anesthetist attitudes toward single-use vials in an academic medical center. J Clin Anesth. 2014;26:125-30.
7. Du Moulin GC, Hedley-Whyte J. Hospital-associated viral infection and the anesthesiologist. Anesthesiology. 1983;59:51-65.
8. Browne R, Chernesky M. Infectious diseases and the anaesthetist. Can J Anaesth. 1988;35:655-65.
9. Zorrilla-Vaca A, Escandón-Vargas K. Bacteriostatic effect of mixtures of1%propofol with 4%lidocaine versus 4% lidocaine alone: regards on microbiologic studies in the field of anesthesiology. Infect Control Hosp Epidemiol. 2014;44:747-9.
10. Ross RS, Viazov S, Gross T, Hofmann F, Seipp H-M, Roggendorf M. Transmission of hepatitis C virus from a patient to an anesthesiology assistant to five patients. N EnglJ Med. 2000;343:1851-4.
11. Tait A, Tuttle D. Preventing perioperative transmission of infection: a survey of anesthesiology practice. Anesth Analg. 1995;80:764-9.
12. El Mikatti N, Dillon P, Healy TE. Hygienic practices of consultant anaesthetists: a survey in the north-west region of the UK. Anaesthesia. 1999;54:13-8.
13. Loftus RW, Koff MD, Birnbach DJ. The dynamics and implications of bacterial transmission events arising from the anesthesia work area. Anesth Analg. 2015;120:853-60.
14. Parlow J. Blood contamination of drug syringes used in anaesthesia. Can J Anaesth. 1989;36:S61-2.
15. Trépanier CA, Lessard MR, Brochu JG, Denault PH. Risk of cross-infection related to the multiple use of disposable syringes. Can J Anaesth. 1990;37:156-9.
16. Blogg CE, Ramsay MA, Jarvis JD. Infection hazard from syringes. Br J Anaesth. 1974;46:260-2.
17. Koepk JW, Reller LB, Masters HA, Selner JC. Viral contamination of intradermal skin test syringes. Ann Allergy. 1985;55:776-8.
18. Lutz CT, Bell CE, Wedner HJ, Krogstad DJ. Allergy testing of multiple patients should no longer be performed with a common syringe. N Engl J Med. 1984;310:1335-7.
19. Ford K. Survey of syringe and needle safety among student registered nurse anesthetists: are we making any progress? AANA J. 2013;81:37-42.
20. Asai T, Matsumoto S, Shingu K, Harmer M. Incidence of blood-borne infectious micro-organisms: would you still not wear gloves? Anaesthesia. 2000;55:591-2.
21. Olds JW, Kisch AL, Eberle BJ, Wilson JN. Pseudomonas aeruginosa respiratory tract infection acquired from a contaminated anesthesia machine. Am Rev Respir Dis. 1972;105:628-32.
22. Postsurgical infections associated with an extrinsically contaminated intravenous anesthetic agent?California, Illinois, Maine, and Michigan, 1990. MMWR Morb Mortal Wkly Rep. 1990;39:426-7.
23. Bennett SN, McNeil MM, Bland La, Arduino MJ, Villarino ME, Perrotta DM, et al. Postoperative infections traced to contamination of an intravenous anesthetic, propofol. N EnglJ Med. 1995;333:147-54.
24. Kidd-Ljunggren K, Broman E, Ekvall H, Gustavsson O. Nosocomial transmission of hepatitis B virus infection through multiple-dose vials. J Hosp Infect. 1999;43:57-62.
25. Tallis G, Ryan G, Lambert S, Bowden D, McCaw R, Birch C, et al. Evidence of patient-to-patient transmissio of hepatitis C virus through contaminated intravenous anaesthetic ampoules. J Viral Hepat. 2003;10:234-9.
26. Centers for Disease Control and Prevention (CDC). Invasive Staphylococcus aureus infections associated with pain injections and reuse of single-dose vials - Arizona and Delaware, 2012. Morb Mortal Wkly Rep. 2012;61:5014.
27. Alter MJ, Ahtone J, Maynard JE. Hepatitis B virus transmission associated with a multiple-dose vial in a hemodialysis unit. Ann Intern Med. 1983;99:330-3.
28. Comstock RD, Mallonee S, Fox JL, Moolenaar RL, Vogt TM, Perz JF, et al. A large nosocomial outbreak of hepatitis C and hepatitis B among patients receiving pain remediation treatments. Infect Control Hosp Epidemiol. 2004;25:576-83.
29. Chant K, Kociuba K, Munro R, Crone S, Kerridge R, Quin J, et al. Investigation of possible patient-to-patient transmission of hepatitis C in a hospital. NSW Public Heal Bull. 1994;5:47-51.
30. Fischer G, Schaefe M, Labus B, Sands L, Rowley P, Azzam I, et al. Hepatitis C virus infections from unsafe injection practices at an endoscopy clinic in Las Vegas, Nevada, 2007-2008. Clin Infect Dis. 2010;51:267-73.
31. Yu H, Tang G, Liaw W, Yien H, Lee T. Pseudomonas cepacia induced septic shock after propofol - a case report. Acta Anaesthesiol Sin. 2000;38:53-6.
32. Massari M, Petrosillo N, Ippolito G, Solforosi L, Bonazzi L, Clementi M. Transmission of hepatitis C virus in a gynecological surgery setting. J Clin Microbiol. 2001;39:2860-3.
33. Centers for Disease Control and Prevention. Transmission of hepatitis B and C viruses in outpatient settings - New York, Oklahoma, and Nebraska, 2000-2002. MMWR Morb Mortal Wkly Rep. 2003;52:901-6.
34. Pugliese G, Gosnell C, Bartley JM, Robinson S. Injection practices among clinicians in United States health care settings. Am J Infect Control. 2010;38:789-98.
35. Hemingway CJ, Malhotra S, Almeida M, Azadian B, Yentis SM. The effect of alcohol swabs and filter straws on reducing contamination of glass ampoules used for neuroaxial injections. Anaesthesia. 2007;62:286-8.
36. Zorrilla-Vaca A, Arevalo J, Escandón-Vargas K, Soltanifar D, Mirski M. Infectious diseases risk and propofol anesthesia, 1989-2015. Emerg Infect Dis. 2015;22:981-92.
37. Zorrilla-Vaca A, Grant M, Mathur V, Li J, Wu C. The impact of neuraxial versus general anesthesia on the incidence of postoperative surgical site infections following knee or hip arthroplasty: a meta-analysis. Reg Anesth Pain Med. 2016;41:555-63.
38. Harrison CA, Rogers DW, Rosen M. Blood contamination of anaesthetic and related staff [see comments]. Anaesthesia. 1990;45:831-3.
39. O’DonnellNG, Asbury AJ. The occupational hazard of human immunodeficiency virus and hepatitis B virus infection. I. Perceived risks and preventive measures adopted by anaesthetists: a postal survey. Anaesthesia. 1992;47:923-8.
40. Rosenberg AD, Bernstein DB, Bernstei RL, Skovron ML, Ramanathan S, Turndorf H. Accidental needlesticks: do anesthesiologists practice proper infection control precautions? Am J Anesthesiol. 1995;22:125-32.
41. McNamara JT, Stacey SG, McCluskey A. Poor anaesthetist hygienic practices - a problem across all grades of anaesthetist. Anaesthesia. 1999;54:718-9.
42. Ryan AJ, Webster CS, Merry AF, Grieve DJ. A national survey of infection control practice by New Zealand anaesthetists. Anaesth Intensive Care. 2006;34:68-74.
43. Carbonne A, Veber B, Hajjar J, Zaro-Goni D, Maugat S, Seguier JC, et al. Evaluation of practices involving a cross infection risk in anaesthesia. Ann Fr Anesth Reanim. 2006;25:1158-64.
44. King C, Ogg M. Safe injection practices for administration of propofol. AORN. 2012;95:365-72.
45. Gounder P, Beers R, Bornschlegel, Katherine Hinterland K, Balter S. Medication injection safety knowledge and practices among anesthesiologists: New York State, 2011. JClin Anesth. 2013;25:521-8.
46. Fernandez PG, Loftus RW, Dodds TM, KoffMD, Reddy S, Heard SO, et al. Hand hygiene knowledge and perceptions among anesthesia providers. Anesth Analg. 2015;120:837-43.
47. Hajjar J, Girard R. Surveillance of nosocomial infections related to anesthesia. A multicenter study. Ann Fr Anesth Reanim. 2000;19:47-53.
48. Zorrilla-Vaca A, Escandón-Vargas K, Brand-Giraldo V, León T, Herrera M, Payán A. Bacterial contamination of propofol vials used in operating rooms of a third-level hospital. Am J Infect Control. 2016;44:e1-3.
49. Zorrilla-Vaca A, Ariza F, León T. Practicas de manipulación del propofol: resultados de un estudio colombiano de corte transversal. Rev Colomb Anestesiol. 2017;45:300-9.
50. ASA Committee On Occupational Health Task Force On Infection Control. Recommendations for Infection Control for the Practice of Anesthesiology. Available from: https://asahq.org/~/media/sites/asahq/files/public/resources/ asa%20committees/recommendations-for-infection-control-for-the-practice-of-anesthesiology-(1).pdf?la=en [cited in:October 20/2015].
51. Association of Anaesthetists of Great Britain and Ireland. Infection control in anaesthesia. Anaesthesia.2008;63:1027-36.
52. Merchant R, Chartrand D, Dain S, Dobson G, Kurrek MM, Lagacé A, et al. Guidelines to the practice of anesthesia -revised edition 2015. Can JAnaesth. 2015;62:54-67.
53. Australian, New Zealand College of Anaesthetists (ANZCA), Australian and New Zealand College of Anaesthetists (ANZCA) guidelines on infection control in anaesthesia. Available from: http://www.anzca.edu.au/documents/ ps28-2015-guidelines-on-infection-control-in-anaes.pdf [cited in: October 20/2015].
54. De Miguel Guijarro A. Recomendaciones para el control de la infeccion en la practica de la anestesia. Rev Esp Anestesiol Reanim. 2013;60 Suppl. 1:86-93.
55. The Hong Kong College of Anaesthesiologists. Guidelines on infection control in anaesthesia; 2015. Available from: https://www.hkca.edu.hk/ANS/standard_publications/guidep15.pdf[cited in: October 20/2015].
56. SASA guidelines for infection control in anaesthesia in South Africa 2014. South Afr Anaesth Analg. 2014;20:S1-39.
57. Rincón Valenzuela DA, Escobar B. Manual de práctica clínica basado en la evidencia: preparación del paciente para el acto quirúrgico y traslado al quirófano. Rev Colomb Anestesiol. 2015;43:32-50.
58. One needle, one syringe, only ONE time. Healthcare coalition launches new training video. AANA NewsBull. 2010;64:17.
59. Siegel JD, Rhinehart E, Jackson M, Chiarello L. 2007 Guideline for isolation precautions: preventing transmission of infectious agents in health care settings. Am J Infect Control. 2007;35:S65-164.
How to Cite
1.
Zorrilla-Vaca A, Escandón-Vargas K. The importance of infection control and prevention in anesthesiology. Colomb. J. Anesthesiol. [Internet]. 2017 Oct. 1 [cited 2024 Apr. 24];45(Supplement):69-77. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/235
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2017-10-01
How to Cite
1.
Zorrilla-Vaca A, Escandón-Vargas K. The importance of infection control and prevention in anesthesiology. Colomb. J. Anesthesiol. [Internet]. 2017 Oct. 1 [cited 2024 Apr. 24];45(Supplement):69-77. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/235
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