Scanning electron micrograph of Enterococcus faecalis, which can infect surgical wounds
Science Photo Library/Alamy
A study of more than 200 people who had spinal surgery suggests that surgical infections may be primarily caused by bacteria already on the skin, rather than external contamination.
Hospitals tend to have strict hygiene standards, including sterilizing surgical gowns and equipment, to prevent such problems, but a US study found 3% of people who have surgery are affected.
Says many post-surgery infections may originate from an individual’s skin microbiome rather than from the hospital environment Dustin Long at the University of Washington in Seattle.
To investigate this idea, Long and his colleagues collected skin swabs from 204 people before and after they underwent different types of spine surgeries.
Fourteen participants subsequently developed wound infections. After analyzing the associated microorganisms, the team found that 12 of the cases involved bacteria that were already part of the patients’ skin microbiome before surgery.
“Almost all SSIs (surgical site infections) we encounter originate from the patient’s own microbiome rather than pathogens introduced from the hospital or operating room,” said team member Stephen Salibantalso at the University of Washington.
Long said the researchers expect similar results from any surgery involving cutting the skin.
They also found that 59% of the infection-causing microorganisms identified in the study were resistant to the preoperative antibiotics all participants received intravenously to prevent such infections. “By characterizing antibiotic resistance signatures in the microbiota before surgery, antibiotic treatment can be tailored to each patient so that it is as effective as possible,” Salicant said.
Future research may also explore the most effective ways to disinfect the skin before surgery, he said.
Despite these findings, a clean hospital environment and sterile surgical instruments remain critical, Long said.
“Much information about the importance of skin bacterial flora in surgical site infections, particularly surgeries involving implanted materials, has been known for decades,” said Roger Beston at the University of Nottingham, UK.
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