The following is a summary of “Importance of targeting intraoperative transmission of bacteria with antibiotic resistance and strain characteristics,” published in the June 2023 issue of the Infection Control by Loftus et al.
Reduce Staphylococcus aureus transmission and infections with intraoperative infection control measures supported by scientific evidence. Researchers’ objective was to determine if transmitted S. aureus isolates are associated with an increased risk of multidrug resistance and related traits. S. aureus isolates obtained from intraoperative environmental, patient skin, and provider hand reservoirs among 274 operating room case pairs (1st and 2nd case of the day) across 3 major academic medical centers from March 2009 to February 2010 were analyzed for clonal transmission events.
Investigators investigated the relationship between clonal S. aureus transmission and multidrug resistance and resistance traits. The transmission dynamics were identified. Transmitted isolates (N=58) were associated with a higher risk of multidrug antibiotic resistance [33% (19/58) shipped vs. 10% (12/115) other isolates, risk ratio 3.14, 99% CI 1.34-7.04, P=0.0006]. The transmission was associated with a significant increase in resistance traits, including mecA [40% transmitted isolates compared to 17% other isolates, risk ratio 2.28, P=0.0026] and ant (6)-Ia [26% transmitted isolates compared to 9% other isolates, risk ratio 2.97, P=0.0050].
The provider’s hands were a common reservoir of origin for multidrug-resistant pathogens, between-case transmission is a standard mode, and the patient epidermis and provider’s hands are common transmission sites. Transmission of S. aureus intraoperatively was linked to multidrug resistance and resistance traits. Targeting intraoperative transmission of multidrug-resistant pathogens necessitates using proven infection control measures.