Objectives: The ISChIA (Infezioni del Sito Chirurgico in Interventi di Artroprotesi) project has been funded by the Italian CCM (Centro Controllo Malattie, Ministry of Health) with the main aim of evaluating the role of microbial air contamination in the risk of surgical site infection (SSI) in hip and knee arthroplasties. This report describes the first results for microbial air contamination in the operating theatres (OTs) included in the survey, focusing on the role of the HVAC (Heating Ventilation and Air Conditioning) system, number of persons and number of door openings during interventions. Methods: Microbial contamination was evaluated in the patient area, when empty and during operations. Passive sampling was used to determine the Index of microbial air contamination (IMA) (Pasquarella et al, 2000) and active sampling (SAS, International PBI) was used to determine cfu/m3. Triptic Soy Agar with incubation at 37°C for 48 hours was used. SSI surveillance, which is still ongoing, is conducted according to the HELICS protocol (2004). Results: From March 2010 to September 2011 a total of 1,396 surgical procedures (60.4% hip and 39.6% knee arthroprostheses) were included: among those 395 were performed in unidirectional airflow OTs, 256 in turbulent air ventilation OTs, 356 in turbulent air ventilation OTs with surgical team wearing Steri-Shield Turbo Helmet (Stryker). Microbial contamination values in empty OTs were: 0.0 IMA and 4±3.6 cfu/m3 (range 0-7) for in unidirectional flow OTs; 0.5±1.1 IMA (range 0-2) and 11.7±16.6 cfu/m3 (range 0-23.5) for turbulent air ventilation OTs. During operations both IMA and cfu/m3 increased: 7.3±7.0 IMA and 50.3±42.0 cfu/m3 in unidirectional airflow OTs; 9.6±13.5 IMA and 58.3±41.2 cfu/m3 in turbulent air ventilation OTs. In turbulent air ventilation OTs with surgical team wearing Steri-Shield Turbo Helmet 4.6±4.1 IMA was obtained. In occupied OTs, a significant positive correlation between mean number of persons/number of door openings and microbial air contamination values was shown. A significant correlation between IMA and cfu/m3 was also found. Conclusion: Few data are available on air quality in OTs. Our preliminary results show a high variability in microbial air contamination values. Notably, the values obtained in unidirectional air flow OTs were higher than the recommended values (HTM03-01,2007; ISPESL,2009; H+ Schweiz,2007). The number of persons and of OT door openings are shown to affect the air bioburden.
Microbial air contamination in operating theatres during hip and knee arthroplasties: first results from the ISChIA project / A., Agodi; F., Auxilia; M., Barchitta; D'Alessandro, Daniela; I., Mura; M., Nobile; C., Pasquarella* on behalf of the GISIO SItI. - ELETTRONICO. - ECCMID 22nd:(2012), pp. P1120-P1120. (Intervento presentato al convegno 22nd European Congress of Clinical Microbiology and Infectious Diseases tenutosi a London nel 31 March - 3 April 2012).
Microbial air contamination in operating theatres during hip and knee arthroplasties: first results from the ISChIA project
D'ALESSANDRO, Daniela;
2012
Abstract
Objectives: The ISChIA (Infezioni del Sito Chirurgico in Interventi di Artroprotesi) project has been funded by the Italian CCM (Centro Controllo Malattie, Ministry of Health) with the main aim of evaluating the role of microbial air contamination in the risk of surgical site infection (SSI) in hip and knee arthroplasties. This report describes the first results for microbial air contamination in the operating theatres (OTs) included in the survey, focusing on the role of the HVAC (Heating Ventilation and Air Conditioning) system, number of persons and number of door openings during interventions. Methods: Microbial contamination was evaluated in the patient area, when empty and during operations. Passive sampling was used to determine the Index of microbial air contamination (IMA) (Pasquarella et al, 2000) and active sampling (SAS, International PBI) was used to determine cfu/m3. Triptic Soy Agar with incubation at 37°C for 48 hours was used. SSI surveillance, which is still ongoing, is conducted according to the HELICS protocol (2004). Results: From March 2010 to September 2011 a total of 1,396 surgical procedures (60.4% hip and 39.6% knee arthroprostheses) were included: among those 395 were performed in unidirectional airflow OTs, 256 in turbulent air ventilation OTs, 356 in turbulent air ventilation OTs with surgical team wearing Steri-Shield Turbo Helmet (Stryker). Microbial contamination values in empty OTs were: 0.0 IMA and 4±3.6 cfu/m3 (range 0-7) for in unidirectional flow OTs; 0.5±1.1 IMA (range 0-2) and 11.7±16.6 cfu/m3 (range 0-23.5) for turbulent air ventilation OTs. During operations both IMA and cfu/m3 increased: 7.3±7.0 IMA and 50.3±42.0 cfu/m3 in unidirectional airflow OTs; 9.6±13.5 IMA and 58.3±41.2 cfu/m3 in turbulent air ventilation OTs. In turbulent air ventilation OTs with surgical team wearing Steri-Shield Turbo Helmet 4.6±4.1 IMA was obtained. In occupied OTs, a significant positive correlation between mean number of persons/number of door openings and microbial air contamination values was shown. A significant correlation between IMA and cfu/m3 was also found. Conclusion: Few data are available on air quality in OTs. Our preliminary results show a high variability in microbial air contamination values. Notably, the values obtained in unidirectional air flow OTs were higher than the recommended values (HTM03-01,2007; ISPESL,2009; H+ Schweiz,2007). The number of persons and of OT door openings are shown to affect the air bioburden.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
