Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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UNKNOWN
NA
70 participants
INTERVENTIONAL
2022-05-17
2024-05-31
Brief Summary
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Research questions Is there a difference in bacterial air contamination during preparation of the sterile surgical goods with 2 persons (intervention) compared with 4-5 persons (control) in the OR? Is there a time-dependent difference in bacterial air contamination pending surgery for 1 hour (control) compared to approximately 12 hours (intervention) when the sterile goods are protected with sterile covers? Is there a time-dependent difference in bacterial air contamination pending surgery if sterile goods are protected or not, by sterile covers? Is there any differences in surgical site infections between the groups? What type of bacteria contain the air contamination? Is there antibiotic resistant bacterial air contamination?
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Detailed Description
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To measure the time pending surgery tables will be arrange with blood agar plates to measure the bacterial air contamination. There will be two tables, one protected with sterile covers and one left without protective covers (in both intervention- and control group).
Outcomes and materials - Primary outcome is bacterial growth isolated by aerobe and anaerobe blood agar plates (haematin agar medium 4.3% w/v \[Colombia Blood Agar Base\] supplemented with 6% w/v chocolatized defibrinated horse blood) and FAA plates (LAB 90 Fastidious Anaerobe Agar 4.6% w/v supplemented with 5% w/v defibrinated horse blood). Secondary outcome is surgical site infections with comparison of bacteria type.
Data collection - A total of 1260 blood agar plates will be used to capture bacterial air contamination. To capture differences in bacterial air contamination during different preparation conditions of the sterile goods, six agar plates (three haematin and three FAA) will be set on a table as the preparation begins. When preparation is complete the agar plates will be collected, by closing the lid of the agar plates. To measure the time-dependant bacterial air contamination pending surgery new agar plates (three haematin and three FAA) which will be set on tables for both intervention- and control group and covered with sterile drapes. To measure the effectiveness of sterile coverage from bacterial air contamination agar plates will be left uncovered pending surgery in both intervention- and control group. When preparing the patient for surgery the covers will be removed and all the plates will be collected by closing the lids.
Microbiology - The plates will be analysed at the Department of Laboratory Medicine, Clinical Microbiology, Örebro University Hospital, according to a specific study protocol. The haematin plates will be incubated at 36°C under aerobic conditions while the FAA plates will be incubated under anaerobic conditions (10% H2, 10% CO2, 80% N2) at 37°C. After 24 and 48 h of aerobic incubation and five days of anaerobic incubation, bacterial growth will be determined quantitatively by counting colony-forming units per plate. The isolates will be identified by routine diagnostic procedures and determined to species level via matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (Microflex LT and Biotyper 3.1, Bruker Daltonik, Bremen, Germany).
Standard antibiotic susceptibility testing for staphylococci will be performed by the disc diffusion test for cefoxitin (30 mg), fusidic acid (10 mg), erythromycin (15 mg), clindamycin (2 mg), trimethoprim/sulfamethoxazole (25 mg), gentamicin (10 mg), norfloxacin (10 mg), ciprofloxacin (5 mg), and rifampin (5 mg) (all antibiotic discs from Oxoid, Basingstoke, UK) with a 0.5 McFarland bacterial suspension in 0.85% NaCl on Mueller-Hinton II agar 3.8% w/v plates (BD Diagnostic Systems, Sparks, MD, USA). After 16-20 h of incubation at 35°C, the zone diameters will be measured and each isolate will be evaluated according to European Committee on Antimicrobial Susceptibility Testing breakpoints (http://www.eucast.org). Isolates resistant to at least three of the antibiotic groups tested will be considered multidrug resistant.
The susceptibility of Cutibacterium acnes to benzylpenicillin and clindamycin will be investigated using a gradient test. Minimum inhibitory concentrations will be determined by Etest (bioMe´rieux, Marcy l'Etoile, France) on FAA plates (LAB M) with 0.5 McFarland suspensions of bacteria in NaCl and incubation at 36°C in an anaerobic atmosphere for 24 h. For metronidazole, a disc (Oxoid) will be used. Bacterial genomic sequencing may be analysed in order to understand if the bacteria derives from the persons within the OR or the hospital environment.
All data regarding postoperative infections will be retrieved from a local register Carath, Department of Cardiothoracic and Vascular surgery. A case report form (CRF) will be used to collect data regarding patient characteristics, OR settings (e.g. temperature, air humidity, number of persons, number of door openings) and surgical data (e.g. type of surgery, time for surgery).
Conditions
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Study Design
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RANDOMIZED
SEQUENTIAL
PREVENTION
SINGLE
Study Groups
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Intervention
In the evening before an elective surgery the sterile surgical goods will be prepared under calm circumstances with only 2 persons in the OR (intervention). Thereafter, the sterile goods will be protected with sterile covers and time pending surgery will be approximately 12 hours (intervention).
Intervention
Less people within the OR but longer waiting time.
Control
The control is to prepare the sterile goods in the morning with more people in the OR (approximately 4-5 persons).
Control
More people in the OR but shorter waiting time
Interventions
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Intervention
Less people within the OR but longer waiting time.
Control
More people in the OR but shorter waiting time
Eligibility Criteria
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Exclusion Criteria
ALL
No
Sponsors
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Camilla Wistrand
OTHER
Responsible Party
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Camilla Wistrand
University Hospital in Örebro
Principal Investigators
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Camilla Wistrand, PhD
Role: PRINCIPAL_INVESTIGATOR
Örebro University, Sweden
Locations
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University Hospital
Örebro, , Sweden
Countries
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Central Contacts
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Facility Contacts
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References
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Wistrand C, Soderquist B, Sundqvist AS. The effect of five versus two personnel on bacterial air contamination during preparation of sterile surgical goods in the operating room: a randomised controlled trial. Antimicrob Resist Infect Control. 2025 Jun 15;14(1):68. doi: 10.1186/s13756-025-01589-4.
Wistrand C, Soderquist B, Friberg O, Sundqvist AS. Bacterial air contamination and the protective effect of coverage for sterile surgical goods: A randomized controlled trial. Am J Infect Control. 2025 Apr;53(4):467-472. doi: 10.1016/j.ajic.2024.12.012. Epub 2024 Dec 16.
Other Identifiers
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BAirCon 2022
Identifier Type: -
Identifier Source: org_study_id
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