Complex Surgical Equipment Can Make Cleaning and Sterilization Difficult

MedicalResearch.com Interview with:
Alex Carignan, MD, MSc

Department of Microbiology and Infectious Diseases
Université de Sherbrooke,
Quebec, Canada 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Although reports of iatrogenic transmission directly linked to surgical power tools (SPTs) are rare, the decontamination of such instruments is challenging due to their complex designs, which may restrict access to cleaning and sterilization agents, and because they often become contaminated after use. Most studies on infection risk with ultrasonic surgical power tools include patients who underwent phacoemulsification surgeries,but it is logical to assume that lumen contaminants, including bacteria and proteinaceous material from previous operations, may be found in neurosurgery SPTs as well.

During June 2015, the infection control department at our institution was notified of an increase in the number of surgical site infection cases following craniotomy since January 2015. We investigated an outbreak of neurosurgical SSIs at a tertiary care hospital in Quebec, Canada, to identify the outbreak’s cause, and our investigation strongly suggests that modifying the reprocessing procedure of an ultrasonic surgical aspirator caused the outbreak.

MedicalResearch.com: What should readers take away from your report?

Response: The outbreak’s features suggest that infections were transmitted by an inadequate cleaning process performed in the sterilization department followed by suboptimal sterilization. It emphasizes the fact that surgical power tools have complex designs that may restrict access to cleaning and sterilization agents. Health care professionals should review and adhere to manufacturers’ assembly/disassembly instructions before using SPTs.

MedicalResearch.com: Is there anything else you would like to add?

Response: I am a medical microbiologist and infectious disease consultant by training, and have also completed a master’s degree in epidemiology at the London School of Hygiene and tropical medicine. I have a special interest in the field of hospital epidemiology, in particular in surveillance and prevention of hospital-associated infections.  The main focus in my research is targeted on hospital-acquired infections (e.g. surgical site infections, ventilator-associated pneumonia, antimicrobial resistant organisms).  

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.

Citation: 

An outbreak of surgical site infections following craniotomy procedures associated with a change in the ultrasonic surgical aspirator decontamination process

Caroline Sheitoyan-Pesant, MD, Isabelle Alarie, MD, Christian Iorio-Morin, MD, PhD,

David Mathieu, MD, Alex Carignan, MD, MSc

DOI: http://dx.doi.org/10.1016/j.ajic.2016.11.020

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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