have been shown to survive in

herpesvirus

Genital secretions

Skin infections

Streptococcus

spp.

Pus

Anthrax

Bacillus anthracis

Skin secretions

Meningitis

Neisseria meningitidis

Cerebrospinal fluid

Acquired immunodeficiency

syndrome (AIDS)

Human immunodeficiency virus

(HIV)

Blood, sexual secretions, body

fluids

Haemorrhagic fevers

Junin, Lassa, Ebola and Marburg

viruses

All bloody products and

secretions

Septicaemia

Staphylococcus

spp.

Blood

Bacteraemia

Coagulase-negative

Staphylococcus

spp. (including

methicillian-resistant

  1. aureus

),

Enterobacter

,

Enterococcus

,

Klebsiella

and

Streptococcus

spp.

Nasal secretion, skin contact

Candidaemia

Candida albicans

Blood

Viral hepatitis A

Hepatitis A virus

Faeces

Viral hepatitis B and C

Hepatitis B and C viruses

Blood and body fluids

Avian influenza

H5N1 virus

Blood, faeces

There is particular concern about infection with human immunodeficiency virus (HIV) and hepatitis viruses B

and C, for which there is strong evidence of transmission from injury by syringe needles contaminated by human

blood, which can occur when sharps waste is poorly managed. Although theoretically any needle-stick injury can

lead to the transmission of bloodborne infections, there is some evidence that hollow needles are associated with

a higher risk of transmission than solid needles, such as suture needles (Puro, Petrosillo & Ippolito, 1995; Trim &

Elliott, 2003; Ganczak, Milona & Szych, 2006). Sharps represent a double risk. They may not only cause physical

injury but also infect these wounds if they are contaminated with pathogens. The principal concern is that infection

may be transmitted by subcutaneous introduction of the causative agent (e.g. viral blood infections).

The existence in health-care facilities of bacteria resistant to antibiotics and chemical disinfectants may also

contribute to the hazards created by poorly managed health-care waste. It has been demonstrated that plasmids

from laboratory strains contained in health-care waste were transferred to indigenous bacteria via the waste

disposal system (Novais et al., 2005). Moreover, antibiotic-resistant

Escherichia coli

 

an activated sludge plant, although there does not seem to be significant transfer of this organism under normal

conditions of wastewater disposal and treatment.

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