TY - JOUR
T1 - Evaluation of potential environmental contamination sources for the presence of multidrug-resistant bacteria linked to wound infections in combat casualties
AU - Keen, Edward F.
AU - Mende, Katrin
AU - Yun, Heather C.
AU - Aldous, Wade K.
AU - Wallum, Timothy E.
AU - Guymon, Charles H.
AU - Cole, David W.
AU - Crouch, Helen K.
AU - Griffith, Matthew E.
AU - Thompson, Bernadette L.
AU - Rose, Joel T.
AU - Murray, Clinton K.
PY - 2012/9
Y1 - 2012/9
N2 - Objective: To determine whether multidrug-resistant (MDR) gram-negative organis are present in Afghanistan or Iraq soil samples, contaminate standard deployed hospital or modular operating roo (ORs), or aerosolize during surgical procedures. Design: Active surveillance. Setting: US military hospitals in the United States, Afghanistan, and Iraq. Methods: Soil samples were collected from sites throughout Afghanistan and Iraq and analyzed for presence of MDR bacteria. Environmental sampling of selected newly established modular and deployed OR high-touch surfaces and equipment was performed to determine the presence of bacterial contamination. Gram-negative bacteria aerosolization during OR surgical procedures was determined by microbiological analysis of settle plate growth. Results: Subsurface soil sample isolates recovered in Afghanistan and Iraq included various pansusceptible members of Enterobacteriaceae, Vibrio species, Pseudomonas species, Acinetobacter lwoffii, and coagulase-negative Staphylococcus (CNS). OR contamination studies in Afghanistan revealed 1 surface with a Micrococcus luteus. Newly established US-based modular ORs and the colocated fixed-facility ORs revealed no gram-negative bacterial contamination prior to the opening of the modular OR and 5 weeks later. Bacterial aerosolization during surgery in a deployed fixed hospital revealed a mean gram-negative bacteria colony count of 12.8 colony-forming units (CFU)/ dm2/h (standard deviation [SD], 17.0) during surgeries and 6.5 CFU/dm2/h (SD, 7.5; P = .14) when the OR was not in use. Conclusion: This study demonstrates no significant gram-negative bacilli colonization of modular and fixed-facility ORs or dirt and no significant aerosolization of these bacilli during surgical procedures. These results lend additional support to the role of nosocomial transmission of MDR pathogens or the colonization of the patient theelves prior to injury.
AB - Objective: To determine whether multidrug-resistant (MDR) gram-negative organis are present in Afghanistan or Iraq soil samples, contaminate standard deployed hospital or modular operating roo (ORs), or aerosolize during surgical procedures. Design: Active surveillance. Setting: US military hospitals in the United States, Afghanistan, and Iraq. Methods: Soil samples were collected from sites throughout Afghanistan and Iraq and analyzed for presence of MDR bacteria. Environmental sampling of selected newly established modular and deployed OR high-touch surfaces and equipment was performed to determine the presence of bacterial contamination. Gram-negative bacteria aerosolization during OR surgical procedures was determined by microbiological analysis of settle plate growth. Results: Subsurface soil sample isolates recovered in Afghanistan and Iraq included various pansusceptible members of Enterobacteriaceae, Vibrio species, Pseudomonas species, Acinetobacter lwoffii, and coagulase-negative Staphylococcus (CNS). OR contamination studies in Afghanistan revealed 1 surface with a Micrococcus luteus. Newly established US-based modular ORs and the colocated fixed-facility ORs revealed no gram-negative bacterial contamination prior to the opening of the modular OR and 5 weeks later. Bacterial aerosolization during surgery in a deployed fixed hospital revealed a mean gram-negative bacteria colony count of 12.8 colony-forming units (CFU)/ dm2/h (standard deviation [SD], 17.0) during surgeries and 6.5 CFU/dm2/h (SD, 7.5; P = .14) when the OR was not in use. Conclusion: This study demonstrates no significant gram-negative bacilli colonization of modular and fixed-facility ORs or dirt and no significant aerosolization of these bacilli during surgical procedures. These results lend additional support to the role of nosocomial transmission of MDR pathogens or the colonization of the patient theelves prior to injury.
UR - http://www.scopus.com/inward/record.url?scp=84864923689&partnerID=8YFLogxK
U2 - 10.1086/667382
DO - 10.1086/667382
M3 - Article
C2 - 22869264
AN - SCOPUS:84864923689
SN - 0899-823X
VL - 33
SP - 905
EP - 911
JO - Infection Control and Hospital Epidemiology
JF - Infection Control and Hospital Epidemiology
IS - 9
ER -