Multiple Reservoirs Contribute to Intraoperative Bacterial Transmission

Loftus, Randy W.; Brown, Jeremiah R.; Koff, Matthew D.; Reddy, Sundara; Heard, Stephen O.; Patel, Hetal M.; Fernandez, Patrick; Beach, Michael L.; Corwin, Howard L.; Jensen, Jens; Kispert, David; Huysman, Bridget C.; Dodds, Thomas M.; Ruoff, Kathryn L.; Yeager, Mark P.

doi:10.1213/ane.0b013e31824970a2

Cited by 128 publications

(127 citation statements)

References 44 publications

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“…45 It has also been associated with a significant increase in 30-day mortality (OR 58.5; 95% CI 2.23 to 1477). 46 In the latter study, several reservoirs were found for bacterial contamination in the operating room. The anesthesiologist remains an important vector for contamination, and both studies highlight the importance of hand washing and maintenance of sterile technique after line insertion.…”

Section: Hand Washing and Venous Access Infectionmentioning

confidence: 87%

Review article: The anesthesiologist’s role in the prevention of surgical site infections

Forbes

McLean

2012

Can J Anesth/J Can Anesth

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Purpose To highlight the role of anesthesiologists in the prophylaxis of surgical site infections (SSIs) and to recognize the central role they play in quality improvement initiatives for the prevention of SSIs. Source The medical literature was searched with a focus on three interventions affecting the risk of SSIs: preoperative antibiotic administration, perioperative normothermia, and perioperative hyperoxia. The literature was also searched for examples of initiatives in patient safety and quality improvement that highlight the role of anesthesiologists in preventing SSIs. Principal findings The timely administration of preoperative antibiotics and the maintenance of perioperative normothermia have been shown to reduce the risk of SSI significantly. Perioperative hyperoxia in the prevention of SSIs remains controversial but may improve outcomes in specific subsets of the surgical population. Initiatives in quality improvement show the challenges faced by many centres to improve upon these processes of care, but they also highlight the role of anesthesiologists as champions in the multidisciplinary efforts for the prevention of SSIs. Conclusions Anesthesiologists are responsible for many of the processes of care shown to impact the risk for SSIs, and they play an important role in the prevention of SSIs.

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Section: Hand Washing and Venous Access Infectionmentioning

confidence: 87%

Review article: The anesthesiologist’s role in the prevention of surgical site infections

Forbes

McLean

2012

Can J Anesth/J Can Anesth

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“…Transmitted bacterial pathogens isolated from intraoperative bacterial reservoirs were directly linked by pulsed-field gelelectrophoresis to 30% of 30-day postoperative infections, including bloodstream, respiratory, urinary tract, and wound infections [9].…”

Section: Intraoperative Bacterial Transmissionmentioning

confidence: 99%

“…Healthcare-associated infections (HCAIs) affect 4-10% of patients admitted to acute care facilities [1][2][3][4][5], are linked to bacterial virulence and resistance [6][7][8], and impact the entire healthcare arena, including the operating room [9][10][11][12]. Postoperative infection prevention requires an understanding of the interplay between bacterial transmission, host defenses, and bacterial strain characteristics associated with increased virulence, transmissibility, and/ or antibiotic resistance.…”

Section: Introductionmentioning

confidence: 99%

Infection control in the operating room

Loftus

2016

Current Opinion in Anaesthesiology

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Recent work has led to the development of evidence-based hand hygiene, environmental cleaning, patient decolonization, and intravascular catheter design and handling improvement strategies. Evidence suggests that a best practice for postoperative infection control is a multimodal program that utilizes these interventions to target patient, provider, and environmental reservoirs in parallel. The development of novel diagnostic tools for targeted attenuation of hyper virulent, transmissible and resistant strains/strain characteristics is indicated to improve patient decolonization efforts.

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“…[1][2][3] There is now evidence that horizontal transmission of pathogens occurs between the anesthesia environment and patients 3 and that OR surfaces are infrequently disinfected. 4,5 Additionally, contamination of patients' intravascular devices during surgery has been recently associated with increased postoperative infections and mortality.…”

mentioning

confidence: 99%

“…4,5 Additionally, contamination of patients' intravascular devices during surgery has been recently associated with increased postoperative infections and mortality. 3 However, the interactions of anesthesia providers with the patient and the environment throughout a surgical case are not well characterized. Understanding the behavioral patterns of current hand hygiene is essential, because this would allow us to tailor hand hygiene guidelines to anesthesiologists in the OR.…”

mentioning

confidence: 99%