Summary
Background
The extent to which the transmission of prophylactic-antibiotic-resistant bacteria
from the anaesthesia work area increases the risk of surgical site infection (SSI)
is unknown. It was hypothesized that the risk of SSI would increase progressively
from no transmission to transmission of prophylactic-antibiotic-resistant isolates.
Methods
This was a retrospective analysis of archival samples collected in two previously
published studies with similar inclusion criteria and sample collection methodology
(observational study 2009–2010 and randomized trial 2018–2019). Archival isolates
were linked by barcode to all patient demographic and procedural information, including
the prophylactic antibiotic administered, transmission and development of SSI. For
this study, all archival isolates underwent prophylactic antibiotic susceptibility
testing, and the ordered association of transmission of Staphylococcus aureus (no transmission, transmission of prophylactic-antibiotic-susceptible isolates and
transmission of prophylactic-antibiotic-resistant isolates) with SSI was assessed.
Results
The risk of development of SSI was 2% (8/406) without S. aureus transmission, 11% (9/84) with transmission of S. aureus isolates that were susceptible to the prophylactic antibiotic used, and 18% (4/22)
with transmission of prophylactic-antibiotic-resistant S. aureus isolates. The Cochrane–Armitage two-sided test for ordered association was P<0.0001. Treating these three groups as 0, 1 and 2, by exact logistic regression,
the odds of SSI increased by 3.59 with each unit increase (95% confidence interval
1.92–6.64; P<0.0001).
Conclusions
Transmission of S. aureus in the anaesthesia work area reliably increases the risk of SSI, especially when
the isolates are resistant to the prophylactic antibiotic administered.
Keywords
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Article info
Publication history
Published online: January 20, 2023
Accepted:
January 12,
2023
Received:
October 26,
2022
Identification
Copyright
© 2023 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.
