Improved Hand Hygiene Can Help Prevent Spread of Post-Surgical Infections

A new study finds that increased adherence to hand hygiene protocols in the operating room (OR) could help stop the spread of Staphyloccocus aureus (S. aureus).

Published in the American Journal of Infection Control (AJIC), the study found that “adherence to evidence-based, basic, preventive measures is abysmal,” according to the University of Iowa researchers. “These failures may help to explain why up to 7% of patients undergoing surgery continue to contract at least one postoperative infection.”

The researchers from the University of Iowa Hospitals and Clinics identified and characterized the epidemiology of particularly pathogenic S. aureus sequence types (ST) in the OR.  S. aureus isolates were collected from three academic medical centers and the transmission dynamics for hyper transmissible, strong biofilm-forming, antibiotic-resistant, and virulent STs were assessed.

“The increase in the spread of S. aureus pathogens beyond the acute care setting is alarming, but we know that there are evidence-based practices that can address this critical patient safety issue,” said lead study author Randy W. Loftus, MD. “The goal of the study was to increase awareness around the transmission of the different strains, with the aim of improving compliance with proven infection control measures.”

Loftus and his colleagues found that S. aureus ST 5 is a more pathogenic strain associated with increased strength of biofilm formation and increased risk of transmission and infection. The combination of ST 5 pathogenicity, an aging patient population, and increasingly complex surgical procedures could explain the increase in the spread of S. aureus infections.

The study confirmed that patient skin surfaces and healthcare provider hands are sources of ST 5 pathogen transmission. This suggests that strict compliance with processes to decolonize patients of bacteria before surgery and to maintain hand hygiene compliance during surgery will likely help control the spread of this strain characteristic.