Gabriel Birgand1, Gaëlle Toupet2, Stephane Rukly3, Gilles Antoniotti4, Marie-Noelle Deschamps5, Didier Lepelletier6, Carole Pornet7, Jean Baptiste Stern8, Yves-Marie Vandamme9, Nathalie van der Mee-Marquet10, Jean-François Timsit11, Jean-Christophe Lucet12. 1. INSERM, IAME, UMR 1137, Paris, France; Universite Paris Diderot, IAME, UMR 1137, Sorbonne Paris Cité, Paris, France; Infection Control Unit, AP-HP, Hôpital Bichat, Paris, France. Electronic address: gbirgand@gmail.com. 2. Infection Control Unit, AP-HP, Hôpital Bichat, Paris, France. 3. INSERM, IAME, UMR 1137, Paris, France; Universite Paris Diderot, IAME, UMR 1137, Sorbonne Paris Cité, Paris, France. 4. Groupe Générale de santé, Direction des risques, Paris, France. 5. Service d'hygiene, clinique Ambroise Paré, Clinique Hartmann, Neuilly-sur-Seine, France. 6. Bacteriology and Infection Control Department, Nantes University Hospital, Nantes, France. 7. Department of Hygiene, Caen University Hospital, Caen, France. 8. Département Thoracique, Institut Mutualiste Montsouris, Paris, France. 9. Department of Infectious Diseases and Internal Medicine, Centre Hospitalier Universitaire d'Angers, Angers, France. 10. Department of Bacteriology and Hospital Hygiene, Trousseau University Hospital, Tours, France. 11. INSERM, IAME, UMR 1137, Paris, France; Universite Paris Diderot, IAME, UMR 1137, Sorbonne Paris Cité, Paris, France; Medical Intensive Care Unit, AP-HP, Hôpital Bichat, Paris, France. 12. INSERM, IAME, UMR 1137, Paris, France; Universite Paris Diderot, IAME, UMR 1137, Sorbonne Paris Cité, Paris, France; Infection Control Unit, AP-HP, Hôpital Bichat, Paris, France.
Abstract
BACKGROUND: The best method to quantify air contamination in the operating room (OR) is debated, and studies in the field are controversial. We assessed the correlation between 2 types of air sampling and wound contaminations before closing and the factors affecting air contamination. METHODS: This multicenter observational study included 13 ORs of cardiac and orthopedic surgery in 10 health care facilities. For each surgical procedure, 3 microbiologic air counts, 3 particles counts of 0.3, 0.5, and 5 μm particles, and 1 bacteriologic sample of the wound before skin closure were performed. We collected data on surgical procedures and environmental characteristics. RESULTS: Of 180 particle counts during 60 procedures, the median log10 of 0.3, 0.5, and 5 μm particles was 7 (interquartile range [IQR], 6.2-7.9), 6.1 (IQR, 5.4-7), and 4.6 (IQR, 0-5.2), respectively. Of 180 air samples, 50 (28%) were sterile, 90 (50%) had 1-10 colony forming units (CFU)/m(3) and 40 (22%) >10 CFU/m(3). In orthopedic and cardiac surgery, wound cultures at closure were sterile for 24 and 9 patients, 10 and 11 had 1-10 CFU/100 cm(2), and 0 and 6 had >10 CFU/100 cm(2), respectively (P < .01). Particle sizes and a turbulent ventilation system were associated with an increased number of air microbial counts (P < .001), but they were not associated with wound contamination (P = .22). CONCLUSIONS: This study suggests that particle counting is a good surrogate of airborne microbiologic contamination in the OR.
BACKGROUND: The best method to quantify air contamination in the operating room (OR) is debated, and studies in the field are controversial. We assessed the correlation between 2 types of air sampling and wound contaminations before closing and the factors affecting air contamination. METHODS: This multicenter observational study included 13 ORs of cardiac and orthopedic surgery in 10 health care facilities. For each surgical procedure, 3 microbiologic air counts, 3 particles counts of 0.3, 0.5, and 5 μm particles, and 1 bacteriologic sample of the wound before skin closure were performed. We collected data on surgical procedures and environmental characteristics. RESULTS: Of 180 particle counts during 60 procedures, the median log10 of 0.3, 0.5, and 5 μm particles was 7 (interquartile range [IQR], 6.2-7.9), 6.1 (IQR, 5.4-7), and 4.6 (IQR, 0-5.2), respectively. Of 180 air samples, 50 (28%) were sterile, 90 (50%) had 1-10 colony forming units (CFU)/m(3) and 40 (22%) >10 CFU/m(3). In orthopedic and cardiac surgery, wound cultures at closure were sterile for 24 and 9 patients, 10 and 11 had 1-10 CFU/100 cm(2), and 0 and 6 had >10 CFU/100 cm(2), respectively (P < .01). Particle sizes and a turbulent ventilation system were associated with an increased number of air microbial counts (P < .001), but they were not associated with wound contamination (P = .22). CONCLUSIONS: This study suggests that particle counting is a good surrogate of airborne microbiologic contamination in the OR.
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