A recent study involving over 200 patients who underwent spinal surgery suggests that postoperative infections may primarily be caused by bacteria present on the skin rather than external contamination.
Scanning electron micrograph of Enterococcus faecalis infecting a wound.
Image Source: Science Photo Library/Alamy
Hospitals often adhere to strict hygiene standards, including disinfection of surgical attire and equipment, to prevent infection issues, yet a study in the United States found that 3% of surgical patients still suffered consequences.
Dustin Long from the University of Washington in the US suggests that many postoperative infections may originate from individuals' skin microbiomes rather than from the hospital environment.
To validate this notion, Long and colleagues collected skin swabs from 204 patients undergoing various spinal surgeries before and after the procedures.
Fourteen participants experienced wound infections postoperatively. Upon analyzing the pathogenic microbes, the research team found that in 12 cases, the bacteria involved were already part of the patients' individual skin microbiomes preoperatively.
Stephen Salipante, also from the University of Washington, remarks, "In fact, all surgical site infections we encountered originated from the patients' own microbiomes rather than being introduced from the hospital or operating room."
The researchers anticipate similar findings for any surgery involving skin incisions.
They also discovered that 59% of the microbes causing infections in the study exhibited resistance to antibiotics administered intravenously to all participants preoperatively for infection prevention.
"Tailoring antibiotic therapy for each patient based on antibiotic resistance traits in their microbiome before surgery could maximize its effectiveness," says Salipante.
He suggests that future research could explore the most effective methods for preoperative disinfection of the human skin.
Long adds that despite these findings, maintaining a clean hospital environment and sterile surgical instruments remain crucial.
