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Redefining Infection Prevention: Superbugs or the Patient’s Own Microbes?

Infection prevention professionals have traditionally held the belief that most hospital-acquired infections (HAIs) are the result of patient exposure to superbugs present in healthcare facilities. However, a mounting body of recent research, including our own, suggests a different narrative. This research shows that the majority of these infections may actually originate from benign bacteria that patients harbor on their own bodies before they are ever admitted to the hospital.

Our research, newly published in Science Translational Medicine, found a correlation between the bacteria residing in our microbiome and those responsible for various infections such as pneumonia, diarrhea, surgical site infections, and bloodstream infections. A significant revelation was that benign bacteria that comfortably inhabit various areas of our bodies when we are in a state of health are often the same microbes accountable for severe infections when our health is compromised.

Other studies have shown surgical site infections to be especially troublesome among all types of healthcare-associated infections. Despite various strategies to avert them ranging from sterilizing surgical equipment, using ultraviolet light for operation room hygiene, abiding by stringent protocols for surgical attire to controlling airflow within the operation room, these infections persist, evident in nearly 1 in 30 surgical procedures without a discernible explanation.

The issue of surgical site infections presents a particularly stubborn challenge as data suggests a lack of significant improvement over time. Moreover, with global antibiotic resistance on the rise, it is expected that infection rates following surgery will increase as antibiotics are a fundamental component of infection prevention during operations.

In our quest to understand and prevent surgical infections, we turned our focus towards spinal surgery given the large number of individuals of both genders who undergo it and because infections following spinal surgery can have devastating consequences for patients, often calling for repeated surgeries and extensive antibiotic regimens for a chance at rectification.

We compared bacteria present on the skin, in the nose, and in the stool of over 200 patients pre-surgery with any infections that occurred post-operation within a three month period. The results were revealing; we found a significant genetic match (86%) between the bacteria on patients’ skin and those causing infections post-spine surgery. This figure mirrored estimates from earlier studies focusing on Staphylococcus aureus.

Interestingly, almost 60% of these infections exhibited resistance to the preventive antibiotics or antiseptics used during surgery, a trait attributed to microbes the patient carried unsuspectingly into the hospital. These antibiotic-resistant bacteria are usually acquired through past antibiotic usage, everyday consumer products, or routine community interactions.

These findings could have profound implications for infection prevention strategies. knowing the most likely source of surgical infection (the patient’s microbiome) beforehand could allow medical teams to find ways to pre-emptively protect against it before the surgery in question. This could herald a move towards more personalized, patient-centered approaches to infection prevention and could potentially offer significant benefits to both, patients and healthcare facilities.

Source: https://theconversation.com/infections-after-surgery-are-more-likely-due-to-bacteria-already-on-your-skin-than-from-microbes-in-the-hospital-new-research-227435

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