Re-examining causes of surgical site infections following elective surgery in the era of asepsis.
Journal
The Lancet. Infectious diseases
ISSN: 1474-4457
Titre abrégé: Lancet Infect Dis
Pays: United States
ID NLM: 101130150
Informations de publication
Date de publication:
03 2020
03 2020
Historique:
received:
19
02
2019
revised:
29
11
2019
accepted:
20
12
2019
pubmed:
2
2
2020
medline:
1
7
2020
entrez:
2
2
2020
Statut:
ppublish
Résumé
The currently accepted assumption that most surgical site infections (SSIs) occurring after elective surgery under standard methods of antisepsis are due to an intraoperative contamination event, remains unproven. We examined the available evidence in which microbial cultures of surgical wounds were taken at the conclusion of an operation and determined that such studies provide more evidence to refute that an SSI is due to intraoperative contamination than support it. We propose that alternative mechanisms of SSI development should be considered, such as when a sterile postoperative wound becomes infected by a pathogen originating from a site remote from the operative wound-eg, from the gums or intestinal tract (ie, the Trojan Horse mechanism). We offer a path forward to reduce SSI rates after elective surgery that includes undertaking genomic-based microbial tracking from the built environment (ie, the operating room and hospital bed), to the patient's own microbiome, and then to the surgical site. Finally, we posit that only by generating this dynamic microbial map can the true pathogenesis of SSIs be understood enough to inform novel preventive strategies against infection following elective surgery in the current era of asepsis.
Identifiants
pubmed: 32006469
pii: S1473-3099(19)30756-X
doi: 10.1016/S1473-3099(19)30756-X
pmc: PMC8019154
mid: NIHMS1673484
pii:
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
e38-e43Subventions
Organisme : NIGMS NIH HHS
ID : R01 GM062344
Pays : United States
Commentaires et corrections
Type : CommentIn
Type : CommentIn
Informations de copyright
Copyright © 2020 Elsevier Ltd. All rights reserved.
Références
Vet Surg. 2016 Feb;45(2):214-22
pubmed: 26757033
World J Surg. 1990 Sep-Oct;14(5):636-41
pubmed: 2238665
Spine J. 2011 Nov;11(11):1042-8
pubmed: 22122837
Spine J. 2019 Feb;19(2):261-266
pubmed: 29859351
Surg Infect (Larchmt). 2019 Feb/Mar;20(2):151-158
pubmed: 30596534
J Am Coll Surg. 2018 May;226(5):719-729
pubmed: 29505823
Ann Surg. 2018 Apr;267(4):749-758
pubmed: 28187042
Infect Control Hosp Epidemiol. 2017 Sep;38(9):1084-1090
pubmed: 28693626
J Pain Res. 2018 Jul 10;11:1297-1305
pubmed: 30022848
World J Gastroenterol. 2018 Apr 21;24(15):1666-1678
pubmed: 29686474
Ann Surg. 2019 Jul;270(1):43-58
pubmed: 30570543
Ann Surg. 2019 Oct;270(4):701-711
pubmed: 31503066
JAMA Surg. 2019 Oct 23;:
pubmed: 31642891
Ann Surg. 2015 Aug;262(2):331-7
pubmed: 26083870
J Long Term Eff Med Implants. 2014;24(2-3):131-8
pubmed: 25272211
Br Med J. 1977 Jan 1;1(6052):20-2
pubmed: 831968
Ann Surg. 2003 Mar;237(3):363-7
pubmed: 12616120
Am J Clin Nutr. 2017 Jul;106(1):10-11
pubmed: 28592601
Surg Infect (Larchmt). 2017 May/Jun;18(4):447-450
pubmed: 28448197
Br J Surg. 2018 Nov;105(12):1680-1687
pubmed: 29974946
JAMA Surg. 2018 Feb 1;153(2):121-122
pubmed: 29049520
Arch Surg. 1991 Feb;126(2):157-63
pubmed: 1825166
Ann Surg. 2012 Feb;255(2):386-93
pubmed: 21989372
Sci Rep. 2018 Feb 26;8(1):3596
pubmed: 29483538
Eur J Surg. 1992 Feb;158(2):109-12
pubmed: 1350211
J Plast Reconstr Aesthet Surg. 2016 Jan;69(1):70-6
pubmed: 26422653
Am J Infect Control. 2017 Nov 1;45(11):1267-1272
pubmed: 28818359
Nat Rev Microbiol. 2011 Mar;9(3):215-22
pubmed: 21297670
Nat Rev Microbiol. 2017 Dec;15(12):740-755
pubmed: 28944770
Sci Rep. 2015 Jun 03;5:10918
pubmed: 26039416
Ann Surg. 2015 Sep;262(3):416-25; discussion 423-5
pubmed: 26258310
Am J Physiol Gastrointest Liver Physiol. 2017 Feb 1;312(2):G112-G122
pubmed: 27979825
J Immunol. 2014 Nov 15;193(10):5171-80
pubmed: 25326026
JAMA Surg. 2017 Mar 1;152(3):292-298
pubmed: 28097305
J Arthroplasty. 2018 Oct;33(10):3246-3251.e1
pubmed: 30054211
Surg Infect (Larchmt). 2019 Jan;20(1):35-38
pubmed: 30234435
Acta Orthop. 2005 Jun;76(3):341-6
pubmed: 16156461
J Long Term Eff Med Implants. 2016;26(3):237-243
pubmed: 28134606
J Hosp Infect. 1991 Jun;18 Suppl A:289-98
pubmed: 1679795
Medicine (Baltimore). 2018 Oct;97(40):e12545
pubmed: 30290611
Sci Transl Med. 2017 May 24;9(391):
pubmed: 28539477
J Am Coll Surg. 2018 May;226(5):804-813
pubmed: 29408507
Nat Med. 2019 Jun;25(6):884-889
pubmed: 31133693
J Gastrointest Surg. 2018 Jul;22(7):1193-1203
pubmed: 29556974
Br J Surg. 2019 Mar;106(4):355-363
pubmed: 30802304
Surgery. 2018 Nov;164(5):921-925
pubmed: 30072247
Ann Surg. 1977 Sep;186(3):251-9
pubmed: 889372
J Hosp Infect. 1998 May;39(1):27-37
pubmed: 9617682
J Surg Res. 2012 May 1;174(1):33-8
pubmed: 21962737
Ann Surg. 1978 Aug;188(2):249-54
pubmed: 686893
AORN J. 2019 Jan;109(1):68-78
pubmed: 30592511
Crit Care Nurs Clin North Am. 2017 Jun;29(2):217-231
pubmed: 28460702
Ann Surg. 2019 Apr;269(4):671-677
pubmed: 29064902
Lancet. 2019 Sep 7;394(10201):840-848
pubmed: 31402112
Clin Orthop Relat Res. 2018 Feb;476(2):345-352
pubmed: 29529667
J Arthroplasty. 2018 May;33(5):1524-1529
pubmed: 29317156
Surg Endosc. 2015 Dec;29(12):3443-53
pubmed: 25801106
Spine J. 2015 Apr 1;15(4):762-70
pubmed: 25637469
Lancet Infect Dis. 2015 Dec;15(12):1429-37
pubmed: 26482597
N Engl J Med. 2010 Sep 9;363(11):1038-49
pubmed: 20825316
J Pharmacol Sci. 2014;126(1):8-13
pubmed: 25168594
Bone Joint J. 2019 Jan;101-B(1_Supple_A):3-9
pubmed: 30648488
Clin Microbiol Infect. 2005 Feb;11(2):155-7
pubmed: 15679493
Curr Rev Musculoskelet Med. 2018 Sep;11(3):325-331
pubmed: 29869135
Surg Annu. 1975;7:279-93
pubmed: 1101404
Proc Natl Acad Sci U S A. 2011 Mar 8;108(10):4152-7
pubmed: 21325608
Curr Opin Infect Dis. 2015 Apr;28(2):158-63
pubmed: 25692267
Nat Rev Genet. 2018 Jan;19(1):9-20
pubmed: 29129921
Surg Infect (Larchmt). 2017 May/Jun;18(4):503-507
pubmed: 28402706
Spine J. 2019 Jun;19(6):1076-1084
pubmed: 30660741
Br J Surg. 2014 Feb;101(3):172-88
pubmed: 24469618
PLoS One. 2013 Oct 30;8(10):e78898
pubmed: 24205344
JAMA Surg. 2014 Oct;149(10):1045-52
pubmed: 25163027