TABLE 1.
Pathogens categorized by mode of transmission and examples of procedures undertaken during CPR that can be transmitted
| Mode of transmission | Pathogensa | Examples of condition(s) leading to transmission during CPR |
|---|---|---|
| Direct transmission | ||
| Contact with blood (blood-borne) | HIV*, HBV*, HCV*, Ebola | Needlestick injury during cannulation and blood sampling |
| Contact with body fluids | Ebola, CCHF virus, Neisseria meningitidis, HSV, Norovirus, HAV, Clostridium difficile, other gastrointestinal pathogens (Salmonella, Shigella) | Contact with pleural fluid during insertion of ICD, contact with saliva during mouth-to-mouth ventilation, contact with feces |
| Contact with skin | VZV, HSV, HPV*, Staphylococcus aureus* and Streptococcus pyogenes* (from impetigo lesions) | Chest compressions without gloves, mouth-to-mouth ventilation |
| Contact with contaminated surfaces | Influenza, Clostridium difficile (spores), SARS-CoV-2(?), CMV | Unprotected handling of equipment |
| Droplet transmission (>5-μm droplet diam) | SARS-CoV-2, MERS-CoV, influenza, CMV | Intubation, suctioning of secretion, administration of nebulized drugs |
| Indirect transmission | ||
| Airborne transmission | Measles, VZV, Mycobacterium tuberculosis, influenza, CMV | Unprotected |
a
*, requires skin breach. Abbreviations: CCHF virus, Crimean-Congo hemorrhagic fever virus; CMV, cytomegalovirus; HAV, hepatitis A virus; HBV, hepatitis B virus; HCV, hepatitis C virus; HIV, human immunodeficiency virus; HPV, human papillomavirus; HSV, herpes simplex virus; ICD, intercostal chest drain; MERS-CoV, Middle East respiratory syndrome coronavirus; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2; VZV, varicella-zoster virus.