United States: A report disclosed yesterday in Science Translational Medicine unveiled that in a study examining patients who encountered infections following spinal surgery, the predominant source of infection-causing bacteria was traced back to their dermal layer before the surgical intervention.
Carried out by scholars from the University of Washington School of Medicine, the investigation scrutinized 210 mature subjects undergoing spinal fusion. The prime objective was to elucidate the persistent incidence of surgical site infections (SSIs), which manifest in about 1 out of 30 surgical procedures, despite rigorous adherence to infection-prevention protocols such as thorough environmental sanitation and meticulous sterile procedures, according to reports by cidrap.umn.edu.
To delve into the origins of the bacteria triggering SSIs, the researchers employed diverse genomic analyses to juxtapose the microbiomes of patients preoperatively with the isolates of SSIs postoperatively.
Among the cohort of 210 patients scrutinized, SSI manifested in 14 individuals (6.8%), and specimens from the nasal passages, rectum, and integumentary system were procured preoperatively from 204 subjects (97.1%). Dermal samples were acquired on the day of the surgical procedure from the precise anatomical area planned for the incision. Genome-wide sequencing analysis of 22 SSI isolates revealed that 19 (86%) bore genomic resemblances to bacterial strains present in one or more preoperative samples from the patients.
Moreover, upon scrutinizing an additional 59 SSIs occurring in patients subjected to surgery within the same medical environment during the study duration, none of the SSIs were attributed to a common bacterial strain.
“This observation suggests that SSIs in the spinal region within our cohort were not induced by exogenous strains emanating from communal reservoirs within the hospital milieu to any discernible degree,” noted the authors of the study, as per cidrap.umn.edu.
Implications for infection-prevention strategy
The analysis also divulged that 59 percent of SSI isolates exhibited resistance to the prophylactic antibiotics administered prior to surgery, and their resistance profiles correlated with the patient’s preoperative resistors.
The authors contend that the revelations and methodological blueprint harbor pragmatic implications for strategies aimed at preventing SSIs, as mentioned by cidrap.umn.edu.
“If these discoveries are corroborated in other procedural cohorts, this paradigm of SSI pathogenesis could precipitate significant paradigm shifts in infection prevention strategies and facilitate more tailored and patient-centric approaches,” they articulated.