Journal article
A threshold of 100 or more colony-forming units on the anesthesia machine predicts bacterial pathogen detection: a retrospective laboratory-based analysis
Canadian journal of anesthesia, Vol.71(5), pp.600-610
05/2024
DOI: 10.1007/s12630-024-02707-3
PMID: 38413516
Abstract
Preventing the spread of pathogens in the anesthesia work area reduces surgical site infections. Improved cleaning reduces the percentage of anesthesia machine samples with ≥ 100 colony-forming units (CFU) per surface area sampled. Targeting a threshold of < 100 CFU when cleaning anesthesia machines may be associated with a lower prevalence of bacterial pathogens. We hypothesized that anesthesia work area reservoir samples returning < 100 CFU would have a low (< 5%) prevalence of pathogens.
In this retrospective cohort study of bacterial count data from nine hospitals, obtained between 2017 and 2022, anesthesia attending and assistants' hands, patient skin sites (nares, axilla, and groin), and anesthesia machine (adjustable pressure-limiting valve and agent dials) reservoirs were sampled at case start and at case end. The patient intravenous stopcock set was sampled at case end. The isolation of ≥ 1 CFU of Staphylococcus aureus, methicillin-resistant Staphylococcus aureus, Enterococcus, vancomycin-resistant Enterococcus, gram-negative (i.e., Klebsiella, Acinetobacter, Pseudomonas, and Enterobacter spp.) or coagulase-negative Staphylococcus was compared for reservoir samples returning ≥ 100 CFU vs those returning < 100 CFU.
Bacterial pathogens were isolated from 24% (7,601/31,783) of reservoir samples, 93% (98/105) of operating rooms, and 83% (2,170/2,616) of cases. The ratio of total pathogen isolates to total CFU was < 0.0003%. Anesthesia machine reservoirs returned ≥ 100 CFU for 44% (2,262/5,150) of cases. Twenty-three percent of samples returning ≥ 100 CFU were positive for ≥ 1 bacterial pathogen (521/2,262; 99% lower confidence limit, 22%) vs 3% of samples returning < 100 CFU (96/2,888; 99% upper limit, 4%).
Anesthesia machine reservoir samples returning < 100 CFU were associated with negligible pathogen detection. This threshold can be used for assessment of terminal, routine, and between-case cleaning of the anesthesia machine and equipment. Such feedback may be useful because the 44% prevalence of ≥ 100 CFU was comparable to the 46% (25/54) reported earlier from an unrelated hospital.
Details
- Title: Subtitle
- A threshold of 100 or more colony-forming units on the anesthesia machine predicts bacterial pathogen detection: a retrospective laboratory-based analysis
- Creators
- Franklin Dexter - Division of Management Consulting, Department of Anesthesia, University of Iowa, 200 Hawkins Drive, 6-JCP, Iowa City, IA, 52242, USA. franklin-dexter@uiowa.eduKaitlin M Walker - RDB Bioinformatics, Iowa City, IA, USACarmen Troncoso Brindeiro - RDB Bioinformatics, Iowa City, IA, USAChase P Loftus - RDB Bioinformatics, Iowa City, IA, USACornelie C L Banguid - RDB Bioinformatics, Iowa City, IA, USARandy W Loftus - Mayo Clinic
- Resource Type
- Journal article
- Publication Details
- Canadian journal of anesthesia, Vol.71(5), pp.600-610
- DOI
- 10.1007/s12630-024-02707-3
- PMID
- 38413516
- NLM abbreviation
- Can J Anaesth
- eISSN
- 1496-8975
- Alternative title
- Un seuil de 100 unités de formation de colonie ou plus sur l’appareil d’anesthésie prédit la détection d’agents pathogènes bactériens : une analyse rétrospective en laboratoire
- Language
- English
- Electronic publication date
- 02/27/2024
- Date published
- 05/2024
- Academic Unit
- Anesthesia
- Record Identifier
- 9984563451902771
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