Journal article
Characterizing periods for rapid testing of bacterial pathogens at ends of surgical cases for interventions in the post-anesthesia care unit or hospital wards using discharge times of patients with and without postoperative healthcare-associated infections
Perioperative care and operating room management, Vol.41, 100576
12/2025
DOI: 10.1016/j.pcorm.2025.100576
Abstract
Background
Earlier studies showed that prevention of Staphylococcus aureus transmission through the anesthesia work area (e.g., from hands of the anesthesiologist to intravenous lumen) resulted in fewer postoperative healthcare-associated infections, specifically surgical site infections. Test results for contamination (e.g., of the anesthesia machine) guide anesthesia clinicians’ efforts. In the studies, a single national laboratory was used, providing such information at least several days later. Future clinical trials could use rapid assays to test reservoirs (e.g., intravenous lumen) at the end of the case for prompt treatment. Study designs depend on knowing how quickly results would be needed.
Methods
The retrospective cohort study was performed using data from 13,512 elective cases performed at a teaching hospital’s inpatient adult surgical suite over 12 months in 2023–2024. Postoperative healthcare-associated infections were obtained from International Classification of Diseases, Tenth Revision, Clinical Modification codes listed <91 days postoperatively, when diagnosed by a surgical team. Different periods from operating room exit were studied (e.g., 1.0, 2.0, and 4.0 h). For each endpoint, 99 % lower one-sided confidence limits for proportions were calculated using intercept-only logistic regression, with robust clustered variance estimation by day.
Results
After 1.0 and 2.0 h, there were 98.9 % (≥97.7 %) and 90.6 % (≥87.3 %) of patients who developed postoperative healthcare-associated infection who had not yet been discharged from the hospital, respectively. There were 89.0 % (≥84.9 %) and 44.2 % (≥38.2 %) who had not yet been discharged from the phase I post-anesthesia care unit. In contrast, at 4.0 h, the lower confidence limits were 76.1 % and 16.5 %, respectively.
Conclusions
Clinical trial designs to evaluate the use of rapid bacterial pathogen tests from anesthesia work areas should plan on results being obtained and used for treatment no greater than 2.0 h after patients exit operating rooms, but <1.0 h is not needed. Medical/surgical nurses throughout the hospital who care for surgical patients would need to be involved, not only post-anesthesia care unit teams.
Details
- Title: Subtitle
- Characterizing periods for rapid testing of bacterial pathogens at ends of surgical cases for interventions in the post-anesthesia care unit or hospital wards using discharge times of patients with and without postoperative healthcare-associated infections
- Creators
- Franklin DexterPaul CoverRandy W. Loftus
- Resource Type
- Journal article
- Publication Details
- Perioperative care and operating room management, Vol.41, 100576
- DOI
- 10.1016/j.pcorm.2025.100576
- ISSN
- 2405-6030
- eISSN
- 2405-6030
- Publisher
- Elsevier
- Language
- English
- Electronic publication date
- 10/15/2025
- Date published
- 12/2025
- Academic Unit
- Anesthesia
- Record Identifier
- 9985016013002771
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