Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Métodos de identificación molecular para Gluconacetobacter diazotrophicus

Los métodos para la identificación de microorganismos se valen de sus características morfológicas, fisiológicas, proteómicas y genómicas. En la identificación tradicional se emplean técnicas dependientes de cultivo que pueden presentar inconvenientes según el tipo de microorganismo a identificar, su capacidad de crecimiento, su parecido con algún otro microbio y el tiempo total para su identificación. El uso de PGPB en la agricultura ha repercutido positivamente reduciendo costos de producción, disminuyendo el impacto negativo sobre el medio ambiente y la salud humana. G. diazotrophicus es una bacteria diazótrofo-endofítica con características de PGPB que tiene un tiempo de crecimiento más extenso en comparación con otras bacterias, y presenta características fenotípicas y genéticas similares a bacterias fijadoras de nitrógeno de su mismo género, por tanto, su identificación empleando únicamente métodos tradicionales puede ser algo laboriosa e inespecífica. En la presente revisión se analizaron algunos de los métodos de identificación molecular utilizados para G. diazotrophicus