Squeri R, Genovese C, Trimarchi G, Antonuccio G M, Alessi V, Squeri A, La Fauci V
Department of Biomedical Sciences and Morphological and Functional Images, University of Messina, Italy.
Postgraduate Medical School of Hygiene and Preventive Medicine, University of Messina, Italy.
Ann Ig. 2019 Mar-Apr;31(2 Supple 1):1-12. doi: 10.7416/ai.2019.2272.
Surgical site infections are among the most frequent Health Care Associated Infections with severe impact on mortality and high economic costs; the role of air microbiological contamination in surgical site infections was amply discussed in the scientific literature, highlighting differences in air contamination rates between different ventilation systems, number of people present and door opening rates.
The aim of our study was to monitor the presence of bacterial air contamination in operating theaters and its relationship with number of people and type of airflow over a period of nine years (January 2010-November 2018) at Messina's University Hospital. The Rho of Spearman test was used to evaluate differences in microbial contamination between empty and working theaters. The impact of the number of people on colony-forming unit values was assessed by performing a stepwise multiple regression analysis. The differences between the results recorded over the nine-year study period were evaluated using the variance analysis. Software R was used for the statistical assessment.
Air samples were taken in each operating theater over nine years. A total of 1,425 samples were collected with a positivity rate of 37.3%. The median bacterial contamination rate was 30 cfu/m3 in empty theaters, while this rate was significantly higher (P < 0.001) in working theaters, where it reached 85 cfu/m3. A statistically significant difference was identified between laminar and turbulent airflow systems, with higher bacterial contamination rates with the latter (p<0.001); in these cases, the value of bacterial contamination (microbial count) was higher in the presence of a higher number of individuals in the operating theater (p<0.001).
Our study demonstrates the complexity of the Operating Theatres environment, in which a good ventilation system is, indeed, only one prerequisite for clean air, but other factors, such as the behavior of healthcare professionals and environmental conditions, can influenced the bacterial count.
手术部位感染是最常见的医疗相关感染之一，对死亡率有严重影响且经济成本高昂；科学文献中充分讨论了空气微生物污染在手术部位感染中的作用，突出了不同通风系统、在场人数和门开启率之间空气污染率的差异。
我们研究的目的是在墨西拿大学医院对手术室中细菌空气污染的存在情况及其与人数和气流类型的关系进行为期九年（2010年1月至2018年11月）的监测。使用Spearman秩相关检验评估空手术室和使用中的手术室之间微生物污染的差异。通过进行逐步多元回归分析评估人数对菌落形成单位值的影响。使用方差分析评估九年研究期间记录结果之间的差异。使用R软件进行统计评估。
九年来在每个手术室采集空气样本。共采集1425个样本，阳性率为37.3%。空手术室的细菌污染率中位数为30 cfu/m3，而在使用中的手术室中该率显著更高（P<0.001），达到85 cfu/m3。在层流和湍流气流系统之间发现了统计学上的显著差异，后者的细菌污染率更高（p<0.001）；在这些情况下，手术室中人数较多时细菌污染值（微生物计数）更高（p<0.001）。
我们的研究表明手术室环境的复杂性，其中良好的通风系统确实只是清洁空气的一个先决条件，但其他因素，如医护人员的行为和环境条件，会影响细菌计数。
