Air contamination for predicting wound contamination in clean surgery: A large multicenter study - 04/05/15
, Gaëlle Toupet, BS c, Stephane Rukly, BS a, b, Gilles Antoniotti, MD d, Marie-Noelle Deschamps, RN e, Didier Lepelletier, MD, PhD f, Carole Pornet, MD g, Jean Baptiste Stern, MD h, Yves-Marie Vandamme, MD i, Nathalie van der Mee-Marquet, PharmD, PhD j, Jean-François Timsit, MD, PhD a, b, k, Jean-Christophe Lucet, MD, PhD a, b, cAbstract |
Background |
The best method to quantify air contamination in the operating room (OR) is debated, and studies in the field are controversial. We assessed the correlation between 2 types of air sampling and wound contaminations before closing and the factors affecting air contamination.
Methods |
This multicenter observational study included 13 ORs of cardiac and orthopedic surgery in 10 health care facilities. For each surgical procedure, 3 microbiologic air counts, 3 particles counts of 0.3, 0.5, and 5 μm particles, and 1 bacteriologic sample of the wound before skin closure were performed. We collected data on surgical procedures and environmental characteristics.
Results |
Of 180 particle counts during 60 procedures, the median log10 of 0.3, 0.5, and 5 μm particles was 7 (interquartile range [IQR], 6.2-7.9), 6.1 (IQR, 5.4-7), and 4.6 (IQR, 0-5.2), respectively. Of 180 air samples, 50 (28%) were sterile, 90 (50%) had 1-10 colony forming units (CFU)/m3 and 40 (22%) >10 CFU/m3. In orthopedic and cardiac surgery, wound cultures at closure were sterile for 24 and 9 patients, 10 and 11 had 1-10 CFU/100 cm2, and 0 and 6 had >10 CFU/100 cm2, respectively (P < .01). Particle sizes and a turbulent ventilation system were associated with an increased number of air microbial counts (P < .001), but they were not associated with wound contamination (P = .22).
Conclusions |
This study suggests that particle counting is a good surrogate of airborne microbiologic contamination in the OR.
Le texte complet de cet article est disponible en PDF.Highlights |
• | We assessed correlations between 2 types of air sampling and wound contaminations. |
• | We included 13 operating rooms of cardiac and orthopedic surgery in 10 health care facilities. |
• | A strong correlation exists between air particle counts and microbial contamination. |
• | Particle counting is a good surrogate of airborne microbiologic contamination. |
• | Laminar airflow was associated with decreased air microbial contamination. |
Key Words : Surgical site infection, Environmental contamination, Operating room, Infectious risk, Laminar airflow, Ventilation systems
Plan
| Funding/Support: Supported by a National Research Grant (no. PREPS 2011-01) (the ARIBO Project). |
|
| Author contributions: Gabriel Birgand contributed to the conception and design, acquisition of data, analysis and interpretation of data, drafting of the article, and final approval of the version to be published. Gaëlle Toupet contributed to the conception and design, acquisition of data, revising of the manuscript, and final approval of the version to be published. Stephane Rukly contributed to the analysis and interpretation of data, revising of the manuscript, and final approval of the version to be published. Gilles Antoniotti contributed to the acquisition of data, revising of the manuscript, and final approval of the version to be published. Marie-Noelle Deschamps contributed to the acquisition of data, revising of the manuscript, and final approval of the version to be published. Didier Lepelletier contributed to the acquisition of data, revising of the manuscript, and final approval of the version to be published. Carole Pornet contributed to the acquisition of data, revising of the manuscript, and final approval of the version to be published. Jean Baptiste Stern contributed to the acquisition of data, revising of the manuscript, and final approval of the version to be published. Yves-Marie Vandamme contributed to the acquisition of data, revising of the manuscript, and final approval of the version to be published. Nathalie Van der Mée – Maquet contributed to the acquisition of data, revising of the manuscript, and final approval of the version to be published. Jean-François Timsit contributed to the analysis and interpretation of data, revising of the manuscript, and final approval of the version to be published. Jean-Christophe Lucet contributed to the conception and design, acquisition of data, analysis and interpretation of data, drafting of the article, and final approval of the version to be published. |
|
| Conflicts of interest: None to report. |
Vol 43 - N° 5
P. 516-521 - mai 2015 Retour au numéro
Article précédent
- Discrepancy in perceptions regarding patient participation in hand hygiene between patients and health care workers
- Min-Kyung Kim, Eun Young Nam, Sun Hee Na, Myoung-jin Shin, Hyun Sook Lee, Nak-Hyun Kim, Chung-Jong Kim, Kyoung-Ho Song, Pyoeng Gyun Choe, Wan Beom Park, Ji-Hwan Bang, Eu Suk Kim, Sang Won Park, Nam Joong Kim, Myoung-don Oh, Hong Bin Kim
- Analysis of microbial load on surgical instruments after clinical use and following manual and automated cleaning
- Síntia de Souza Evangelista, Simone Gonçalves dos Santos, Maria Aparecida de Resende Stoianoff, Adriana Cristina de Oliveira
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?