A new study published in Science Translational Medicine suggests that the main culprit behind surgical infections is the skin microbiome rather than hospital superbugs.
As a result, they urge a personalised infection prevention approach to halt infections by leveraging information about a patient’s skin microbiome before surgery.
The team’s findings challenge traditional beliefs about the origin of infections acquired during hospital stays.
Contrary to popular belief, the research reveals that most healthcare-associated infections stem from bacteria naturally residing on patients’ skin rather than from superbugs in medical facilities.
The research, conducted by a multidisciplinary team of physician-scientists from Harborview Medical Centre at the University of Washington, examined the genetic data of bacteria that cause infections such as pneumonia, diarrhoea, bloodstream infections, and surgical site infections.
The findings suggest that harmless bacteria present on our bodies during good health can become harmful pathogens when our immune system is compromised.
Among hospital-acquired infections, surgical site infections pose a significant challenge.
A 2013 study highlighted that these infections account for over 33% of the annual costs associated with hospital-acquired infections in the US, amounting to a staggering US$9.8 billion.
Surgical site infections are a leading cause of hospital readmissions and post-surgery fatalities.
Despite hospitals’ rigorous infection prevention protocols, including sterilisation of surgical equipment and UV light cleaning of operating rooms, surgical site infections still occur in approximately 1 out of every 30 procedures.
Alarmingly, because of the global rise in antibiotic resistance, the problem is expected to worsen, as antibiotics are a critical preventive measure against these infections.
To better understand the root causes of surgical site infections, the researchers focused on spinal surgery, a procedure that requires significant healthcare resource allocation and has the potential for severe infection complications.
They collected samples from the noses, skin, and stools of 200-plus patients before surgery and monitored them for 90 days after surgery.
The study revealed that 86% of the bacteria causing infections after spinal surgery were genetically identical to those present on the patients’ skin before the surgery.
Nearly 60% of these infections showed resistance to the antibiotics administered during surgery, indicating that the antibiotic-resistant bacteria were already present on the patients’ bodies before admission.
The findings suggest a paradigm shift in infection prevention strategies. Instead of focusing solely on the sterility of the hospital environment, personalised, patient-centred approaches are needed to effectively prevent surgical site infections.
The research team believes that leveraging information about a patient’s skin microbiome before surgery could help tailor preventive measures, such as selecting targeted antibiotics that are more effective against the specific bacteria present.
This individualised approach could lead to better outcomes for hospitals and patients.
While more research is needed to refine these strategies, the study underscores the critical role of understanding the patient’s microbiome in preventing hospital-acquired infections.
