Health care providers and patients have long believed that infections acquired in hospitals are due to superbugs present in medical facilities. However, new genetic data reveals that most health care-associated infections actually stem from harmless bacteria already residing on patients’ bodies prior to their hospital admission. Research indicates that these bacteria, part of the natural microbiome, are responsible for causing severe infections such as pneumonia, diarrhea, bloodstream infections, and surgical site infections when patients become ill.
Among the various health care-associated infections, surgical site infections pose a significant challenge. These infections contribute significantly to the overall costs of hospital-acquired infections, comprising over 33% of the annual expenses. Moreover, they are a leading cause of hospital readmissions and mortality post-surgery. Despite meticulous infection prevention protocols followed by hospitals, the occurrence of surgical site infections remains relatively high, affecting approximately 1 in every 30 procedures.
A team of physician-scientists embarked on a study focused on understanding the origins of surgical infections, particularly in spinal surgery. They conducted extensive research on over 200 patients undergoing spinal procedures, analyzing the bacteria present in their nose, skin, and stool before surgery and monitoring any subsequent infections. The results unveiled a correlation between the types of bacteria colonizing specific regions of the skin and the occurrence of infections post-surgery. Surprisingly, 86% of the bacteria causing infections were genetically linked to pre-existing bacteria in the patients’ bodies.
Antibiotic Resistance: A Growing Concern
Furthermore, the study revealed that a substantial percentage of infections were resistant to the preventive antibiotics administered during surgery. This antibiotic resistance was not acquired in the hospital environment but was carried unknowingly by the patients from their own microbiomes. Factors such as prior antibiotic exposure, consumer products, or routine community interactions may contribute to the development of antibiotic-resistant microbes.
The findings suggest a paradigm shift in infection prevention strategies, moving towards personalized approaches based on an individual’s microbiome. While current protocols rely on standard preventive measures for all patients, personalized interventions tailored to the patient’s specific bacterial makeup could enhance the efficacy of infection prevention. By leveraging information about a patient’s microbiome, clinicians could select more targeted antimicrobials, potentially reducing the risk of post-surgery infections.
The traditional focus on maintaining a sterile hospital environment has been effective in preventing certain infections. However, the emerging understanding that infections often originate from patients’ own microbiomes highlights the need for a shift towards patient-centered, individualized infection prevention approaches. By acknowledging the role of the patient’s microbiome in infection risk, healthcare providers can better safeguard patients undergoing surgical procedures and improve overall outcomes.
Unveiling the origins of surgical site infections sheds light on the critical role of patients’ microbiomes in infection development. By recognizing the significance of personalized infection prevention strategies and incorporating patient-centered care principles, hospitals can enhance their infection control practices and improve patient outcomes in the surgical setting.