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Effect of mobile laminar airflow units on airborne bacterial contamination during neurosurgical procedures
Karolinska University Hospital, Sweden; Karolinska Institutet, Sweden.
Karolinska University Hospital, Sweden; Karolinska Institutet, Sweden.
Tobii Pro Insight, Sweden.
RISE - Research Institutes of Sweden, Bioscience and Materials, Chemistry and Materials.
2018 (English)In: Journal of Hospital Infection, ISSN 0195-6701, E-ISSN 1532-2939, Vol. 99, no 3, p. 271-278Article in journal (Refereed) Published
Abstract [en]

Background: Surgical site infections (SSIs) after neurosurgery are potentially life-threatening and entail great costs. SSIs may occur from airborne bacteria in the operating room, and ultraclean air is desired during infection-prone cleaning procedures. Door openings and the number of persons present in the operating room affect the air quality. Mobile laminar airflow (MLAF) units, with horizontal laminar airflow, have previously been shown to reduce airborne bacterial contamination. Aim: To assess the effect of MLAF units on airborne bacterial contamination during neurosurgical procedures. Methods: In a quasi-experimental design, bacteria-carrying particles (colony-forming units: cfu) during neurosurgical procedures were measured with active air-sampling in operating rooms with conventional turbulent ventilation, and with additional MLAF units. The MLAF units were shifted between operating rooms monthly. Colony-forming unit count and bacterial species detection were conducted after incubation. Data was collected for a period of 18 months. Findings: A total of 233 samples were collected during 45 neurosurgical procedures. The use of MLAF units significantly reduced the numbers of cfu in the surgical site area (P < 0.001) and above the instrument table (P < 0.001). Logistic regression showed that the only significant predictor affecting cfu count was the use of MLAF units (odds ratio: 41.6; 95% confidence interval: 11.3–152.8; P < 0.001). The most frequently detected bacteria were coagulase-negative staphylococci. Conclusion: MLAF successfully reduces cfu during neurosurgery to ultraclean air levels. MLAF units are valuable when the main operating room ventilation system is unable to produce ultraclean air in infection-prone clean neurosurgery.

Place, publisher, year, edition, pages
2018. Vol. 99, no 3, p. 271-278
Keywords [en]
Colony counts, Laminar airflow, Neurosurgery, Operating room, air conditioning, air quality, air sampling, airborne bacterium, Article, bacterium contamination, coagulase negative Staphylococcus, colony forming unit, mobile laminar airflow, nonhuman, quasi experimental study, risk factor, bacterial count, bacterium, classification, controlled clinical trial (topic), human, isolation and purification, microbiology, microclimate, preventive health service, Air Microbiology, Bacteria, Colony Count, Microbial, Environment, Controlled, Humans, Mobile Health Units, Neurosurgical Procedures, Non-Randomized Controlled Trials as Topic
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Natural Sciences
Identifiers
URN: urn:nbn:se:ri:diva-36574DOI: 10.1016/j.jhin.2018.03.024Scopus ID: 2-s2.0-85046144800OAI: oai:DiVA.org:ri-36574DiVA, id: diva2:1268786
Available from: 2018-12-06 Created: 2018-12-06 Last updated: 2018-12-06Bibliographically approved

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