皮肤深处的细菌库是手术部位和生物材料相关感染的潜在来源
C Guarch-Pérez1, M Riool1, L de Boer1
1Department of Medical Microbiology and Infection Prevention, Amsterdam Institute for Infection and Immunity, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
The Journal of hospital infection
|August 6, 2023
概括
通过消毒不能完全清除的深层皮肤细菌,可以在切割过程中污染手术伤口. 这种污染,特别是来自像Staphylococcus epidermidis这样的物种,是手术部位和生物材料相关感染的关键来源.
科学领域:
- 微生物学 微生物学
- 传染性疾病 传染性疾病
- 手术创新 在外科创新.
背景情况:
- 手术部位感染 (SSI) 和生物材料相关感染 (BAI) 仍然是一个重大的临床挑战.
- 手术伤口中微生物污染的确切来源尚未完全理解.
- 标准的手术前皮肤消毒可能无法消除深藏在皮肤结构中的细菌.
研究的目的:
- 调查皮肤微生物群对手术伤口污染的贡献.
- 为了确定来自更深层皮肤的细菌是否可以在切口后殖民于伤口.
- 为了确定潜在的SSIs和BAIs中涉及的常见细菌物种.
主要方法:
- 这是一项初步的队列研究,涉及99名创伤手术患者.
- 从患者皮肤 (消毒前和后),刀片和手术伤口中分离,定量和识别有氧和无氧细菌.
- 在2020年5月至2021年2月期间进行的分析.
主要成果:
- 99%的患者在消毒前对细菌培养呈阳性; 在赫西丁消毒后,40%的患者仍然呈阳性.
- 54%的阳性后消毒培养患者在切割皮肤后出现伤口污染.
- 经常发现葡萄球菌表皮菌和Cutibacterium;9%的伤口有100个以上的殖民地,这是BAI的潜在门.
结论:
- 在较深的皮肤层中存在的细菌,不能通过消毒消除,可以在切口期间引入外科创伤.
- 这种手术内污染是SSI和BAI发展的重要因素.
- 针对更深层的皮肤水库可能对预防手术感染至关重要.
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