Surveillance of Environmental and Procedural Measures of Infection Control in the Operating Theatre Setting

Abstract

The microbiological contamination of operating theatres and the lack of adherence to best practices by surgical staff represent some of the factors affecting Surgical Site Infections (SSIs). The aim of the present study was to assess the microbiological quality of operating settings and the staff compliance to the SSI evidence-based control measures. Ten operating rooms were examined for microbiological contamination of air and surfaces, after cleaning procedures, in “at rest” conditions. Furthermore, 10 surgical operations were monitored to assess staff compliance to the recommended practices. None of the air samples exceeded microbiological reference standards and only six of the 200 surface samples (3.0%) were slightly above recommended levels. Potentially pathogenic bacteria and moulds were never detected. Staff compliance to best practices varied depending on the type of behaviour investigated and the role of the operator. The major not compliant behaviours were: pre-operative skin antisepsis, crowding of the operating room and hand hygiene of the anaesthetist. The good environmental microbiological quality observed is indicative of the efficacy of the cleaning-sanitization procedures adopted. The major critical point was staff compliance to recommended practices. Awareness campaigns are therefore necessary, aimed at improving the organisation of work so as to facilitate compliance to operative protocols.

Bacterial profiles and their antimicrobial susceptibility pattern of Isolates from inanimate hospital environments at Tikur Anbessa Specialized Teaching Hospital, Addis Ababa, Ethiopia

“…Higher levels of bacterial contamination observed in our study could be attributed primarily to the use of ineffective disinfectants during surface cleaning, and inadequate uses of standard precautions such as hand hygiene and contact precautions, as well as migration of the organisms through air flow or other means particularly in places where the ventlation system has not been not in place or not working properly [20]. Infrequent cleaning of inanimate surfaces and medical equipments could also contribute to poor microbial quality of the hospital surfaces [14,30,31].…”

“…Sampling sites around a bed in each ICUs and OTs were chosen based on the frequency with which the surfaces were touched. Sterile swabs were moistened in Brain Heart Infusion (BHI) and then, were used to swab (i) commonly touched medical equipment including beds, monitors, OR-light, linens, ventilators, oxygen supply, anesthesia machine, suction buttons and Laparoscopy (ii) workstation, including keyboards, computer mice; (iii) environments including floors, wall and corridors; (iv) Lobby (furniture) including chair, table, lockers and trowels; (v) Sinks; (vi) hospital textiles including bed linen based on methods described previously [17][18][19][20].…”

Risk Factors for Wound Infection Following Caesarean Section: A Case Control Study from Sir Salimullah Medical College & Mitford Hospital in Dhaka, Bangladesh

“…While SSIs most commonly manifest between the fifth to eight post-operative days, some SSIs may manifest as early as the third postoperative day depending on the type of bacterial infection [10] [11]. CS-SSI is diagnosed by documenting the typical clinical signs of inflammation, redness, pain and discharge of purulent material [12].…”

Analysis of influencing factors of incision infection in combined anterior-posterior surgery for subaxial cervical fracture dislocation

“…There are bacterial colonies on the surface of human skin. The increase in the number of people in the operating room will increase the total number of bacterial colonies in the air of the operating room [15][16][17]. In addition, the number of bacterial colonies in the operating room has a certain rule during the operation, which is manifested as the maximum at the beginning, a decrease during the operation, and a peak value at the end.…”