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Microbial contamination associated with routine aseptic practice
N A Klapes1, V W Greene, A C Langholz
1University of Minnesota, Division of Environmental and Occupational Health, Minneapolis 55455.
The Journal of Hospital Infection
|November 1, 1987
Summary
Routine aseptic technique in hospitals results in a 2.7% contamination rate, indicating that even without observed breaches, surgical sterility is not guaranteed. Microbial contamination is a measurable, low-level risk in clinical settings.
Area of Science:
- Microbiology
- Healthcare Infection Control
- Surgical Sciences
Background:
- Routine aseptic technique is fundamental in preventing surgical site infections.
- The effectiveness of aseptic practices under real-world operational conditions requires continuous evaluation.
- Understanding contamination rates is crucial for optimizing sterile processing and patient safety.
Purpose of the Study:
- To quantify the rate of fortuitous microbial contamination during routine aseptic technique in clinical settings.
- To compare contamination rates in a hospital environment with those achieved under industrial sterility standards.
- To assess whether current aseptic practices guarantee complete sterility.
Main Methods:
- Stainless steel strips, simulating surgical instruments, were placed in sterilized surgical packs.
- Nursing personnel assayed the strips during routine surgical and invasive procedures across three hospitals.
- Contamination rates were analyzed based on the 36 investigators and compared to cleanroom assays.
Main Results:
- Observed contamination rates among 36 investigators ranged from 0% to 11.3%, with an overall average of 2.7%.
- In contrast, assays under industrial cleanroom conditions yielded a contamination rate of 0.16%.
- These findings highlight a significant difference between idealized and operational sterility.
Conclusions:
- Routine aseptic technique, even when performed meticulously, does not ensure complete sterility.
- Surgical sterility should be understood as a state of low-level, measurable microbial contamination.
- The study underscores the need for ongoing vigilance and potential improvements in aseptic protocols to minimize microbial exposure.