Multiple Reservoirs Contribute to Intraoperative Bacterial Transmission Full Text
Anesthesia & Analgesia, 05/24/2012
Exclusive author commentary
Loftus RW et al. – Bacterial contamination of patients, provider hands, and the environment contributes to stopcock transmission events, but the surrounding patient environment is the most likely source. Stopcock contamination is associated with increased patient mortality. Patient and provider bacterial reservoirs contribute to 30–day postoperative infections. Multimodal programs designed to target each of these reservoirs in parallel should be studied intensely as a comprehensive approach to reducing intraoperative bacterial transmission.
Randy W. Loftus (05/24/2012) comments:
Healthcare-associated infections (HCAIs) continue to affect an alarming number of patients admitted to acute care facilities. We hypothesize that a better understanding of bacterial cross contamination, the underlying mechanism for HCAI development, will lead to improved HCAI preventive measures and sustained reductions in patient morbidity and mortality. We have utilized a validated experimental model to gain insight into the underlying mechanisms, sources of, and risk factors for intraoperative bacterial transmission events. This work strongly suggests that a multimodal approach targeting improvements in anesthesia provider hand hygiene compliance, patient decolonization, environmental decontamination, and intravascular device design and handling in parallel during patient care is necessary to maximally suppress intraoperative bacterial transmission and associated 30-day postoperative HCAIs. This is the next step beyond Surgical Care Improvement Project (SCIP) measures.