Cristina M L, Sartini M, Schinca E, Ottria G, Spagnolo A M
Department of Health Sciences, University of Genoa, Italy.
J Prev Med Hyg. 2016 Sep;57(3):E142-E148.
The rate of surgical site infections (SSI) is strongly influenced by operating room quality, which is determined by the structural features of the facility and its systems and by the management and behavior of healthcare workers. The aim of the present study was to assess microbial contamination in the operating room during hip- and knee-replacement procedures, the behavior of operating room staff and the incidence of SSI through postdischarge surveillance.
Microbial contamination was evaluated by active and passive sampling at rest and in operating conditions. Organizational and behavioral characteristics were collected through observational assessment. The incidence of SSI was evaluated in 255 patients, and follow-up examinations were carried out 30 and 365 days after the procedure.
The mean values of the airborne and sedimenting microbial loads were 12.90 CFU/m and 0.02 CFU/cm2/h, respectively. With regard to outcome, the infection rate proved to be 0.89% and was associated with knee-replacement procedures. The microorganism responsible for this superficial infection was Staphylococcus aureus.
Clinical outcomes proved to be satisfactory, owing to the limited microbial load (in both at-rest and operating conditions), the appropriate behavior of the staff, compliance with the guidelines on preoperative antibiotic prophylaxis, and efficient management of the ventilation system.
手术部位感染（SSI）的发生率受手术室质量的影响很大，而手术室质量取决于设施及其系统的结构特征以及医护人员的管理和行为。本研究的目的是通过出院后监测评估髋关节和膝关节置换手术期间手术室的微生物污染情况、手术室工作人员的行为以及SSI的发生率。
通过在静止状态和手术状态下进行主动和被动采样来评估微生物污染。通过观察性评估收集组织和行为特征。对255例患者的SSI发生率进行评估，并在手术后30天和365天进行随访检查。
空气传播和沉降微生物负荷的平均值分别为12.90 CFU/m和0.02 CFU/cm²/h。就结果而言，感染率为0.89%，且与膝关节置换手术有关。导致这种浅表感染的微生物是金黄色葡萄球菌。
由于微生物负荷有限（在静止状态和手术状态下均如此）、工作人员行为得当、遵守术前抗生素预防指南以及通风系统管理有效，临床结果令人满意。
