Genetic relationship between bacteria isolated from intraoperative air samples and surgical site infections at a major teaching hospital in Ghana
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Date
2019-11-16
Journal Title
Journal ISSN
Volume Title
Publisher
Journal of Hospital Infection
Abstract
Background: In low- and middle-income countries (LMICs) the rate of surgical site infections
(SSI) is high, leading to negative patient outcomes and excess healthcare costs. A
causal relationship between airborne bacteria in the operating room and SSI has not been
established, at a molecular or genetic level. We studied the relationship between intraoperative
airborne bacteria and bacteria causing SSI in an LMIC.
Methods: Active air sampling using a portable impactor was performed during clean or
clean-contaminated elective surgical procedures. Active patient follow-up consisting of
phone calls and clinical examinations was performed 3, 14 and 30 days after surgery.
Bacterial isolates recovered from SSI and air samples were compared by matrix-assisted
laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF) identification,
ribotyping, whole genome sequencing (WGS), and metagenomic analysis.
Results: Of 128 included patients, 116 (91%) completed follow-up and 11 (9%) developed
SSI. Known pathogenic bacteria were isolated from intraoperative air samples in all cases
with SSI. A match between air and SSI isolates was found by MALDI-TOF in eight cases.
Matching ribotypes were found in six cases and in one case both WGS and metagenomic
analysis showed identity between air- and SSI-isolates.
Conclusion: The study showed high levels of intraoperative airborne bacteria, an SSIrate
of 9% and a genetic link between intraoperative airborne bacteria and bacteria
Description
Research Article
Keywords
Surgical site infections, Airborne bacteria, Low- and middle-income, countries, Staphylococcus aureus
Citation
Stauning MA et al., Genetic relationship between bacteria isolated from intraoperative air samples and surgical site infections at a major teaching hospital in Ghana, Journal of Hospital Infection, https://doi.org/10.1016/j.jhin.2019.11.007