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In a groundbreaking discovery, new research published in Science Translational Medicine challenges the long-held belief that hospital-acquired infections are primarily caused by exposure to superbugs within medical facilities. Instead, the study suggests that the bacteria responsible for most health care-associated infections are already present on patients’ bodies before they even enter the hospital.
Led by a team of physician-scientists from Harborview Medical Center at the University of Washington, the study utilized advanced genetic analysis techniques to compare bacteria in patients’ microbiomes—those inhabiting various areas of the body—with the bacteria causing infections such as pneumonia, diarrhea, bloodstream infections, and surgical site infections. The findings shed light on a previously overlooked aspect of infection prevention.
Surgical site infections, in particular, have emerged as a persistent challenge in the healthcare sector. Despite stringent protocols aimed at preventing such infections—including sterilization of equipment, rigorous cleaning procedures, and adherence to strict attire and airflow regulations in operating rooms—surgical site infections continue to occur following approximately 1 in 30 procedures. These infections not only contribute significantly to healthcare costs but also pose serious risks to patient health, often leading to hospital readmission and, in some cases, death.
The study focused specifically on infections following spinal surgery, a procedure with significant implications for patients’ quality of life and healthcare resources. Over a one-year period, researchers analyzed bacteria samples from the nose, skin, and stool of over 200 patients prior to surgery, tracking any subsequent infections over a 90-day period.
The results were striking. Despite variations in the species of bacteria present on patients’ skin, clear patterns emerged linking specific bacterial communities to regions of the body undergoing surgery. Astonishingly, 86% of the bacteria causing infections after spinal surgery were found to be genetically matched to bacteria already present on the patient’s body before the procedure.
Furthermore, nearly 60% of these infections exhibited resistance to the preventive antibiotics administered during surgery—a resistance likely acquired outside of the hospital environment. Factors such as prior antibiotic exposure, consumer products, or routine community contact were identified as potential sources of antibiotic-resistant microbes.
These findings have significant implications for infection prevention strategies in healthcare settings. Traditionally, infection prevention protocols have been based on a one-size-fits-all approach, often overlooking the individual microbiome of each patient. However, the study suggests that personalized approaches to infection prevention, informed by a patient’s unique microbiome, could lead to more effective outcomes.
While further research is needed to fully understand the implications of these findings, the study underscores the importance of shifting towards patient-centered approaches to infection prevention. By leveraging insights from the patient microbiome, healthcare providers may be better equipped to tailor preventive measures, ultimately improving outcomes for both hospitals and patients alike.
