Spread of coagulase-negative staphylococci during cardiac operations in a modem operating room
Spread of coagulase-negative staphylococci during cardiac operations in a modem operating room
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DOI：
10.1016/s0003-4975(99)01432-0
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发表时间：
2000-04-01
影响因子：
4.6
通讯作者：
Ransjö, U
中科院分区：
文献类型：
--
作者：
Bitkover, CY;Marcusson, E;Ransjö, U
背景凝固酶阴性葡萄球菌导致33%至62.5%的心脏手术后伤口感染。本研究的目的是调查胸骨伤口中凝固酶阴性葡萄球菌的来源。前瞻性研究了在分区通风手术室中进行的20例手术。从房间里的所有人、胸骨伤口和空气中采集培养物。对肉眼判断为凝固酶阴性葡萄球菌的分离株进行代谢分类，并通过脉冲场凝胶电泳对相似的分离株进行研究。手术室空气中的细菌计数非常低。20例手术中有13例发现伤口污染。可以追踪到六个伤口分离物，三个在患者的胸骨皮肤，一个在患者的腹股沟，一个在外科医生的鼻子，一个在外科医生的手臂和前额以及助手的鼻子。三个手术现场空气培养可以追溯到擦洗手术室工作人员。1例胸骨浅表伤口感染为金黄色葡萄球菌感染，术中未能从伤口中分离出金黄色葡萄球菌。在超净环境中，胸骨伤口中的细菌来自患者自己的皮肤和手术团队。(C)2000年由胸外科医师协会出版。
Background. Coagulase-negative staphylococci cause 33% to 62.5% of wound infections after cardiac operations. The aim of this study was to investigate the sources of coagulase-negative staphylococci in the sternal wound.Methods. Twenty operations performed in zonal ventilated operating rooms were investigated prospectively. Cultures were taken from all persons present in the room, the sternal wound, and the air. Isolates macroscopically judged to be coagulase-negative staphylococci were metabolically classified, and similar isolates were investigated by pulsed-field gel electrophoresis.Results. Bacterial counts in the operating room air were very low. Wound contamination was found in 13 of 20 operations. Six wound isolates could be traced, three to the patients' sternal skin, one to the patient's groin, one to the surgeon's nose, and one to the surgeon's arm and forehead and the assistant's nose. Three operating field air cultures could be traced to the scrubbed theatre staff. The single case of superficial sternal wound infection was caused by Staphylococcus aureus, which was not isolated from the wound at operation.Conclusions. In an ultraclean environment, bacteria in the sternal wound originated from the patients' own skin and from the surgical team. (C) 2000 by The Society of Thoracic Surgeons.