Operating theatre ventilation systems and microbial air contamination in total joint replacement surgery: results of the GISIO-ISChIA study

D'Amico, Alessandro

Fara, Gaetano

English

FARA, Gaetano

Archivio della ricerca- Università di Roma La Sapienza

Ann Ig 2016; 28: 379-380   doi:10.7416/ai.2016.2119LETTER’sThe need to develop a multidisciplinary expertise for the microbiological safety of operating theatresSurgical site infection (SSI) is a major complication following surgery and is associated with increased morbidity and mortality, as well as increased costs (1). Over the past decades, the role of air as a vehicle of infection has been the subject of much interest and debate (1, 2). Guidelines for the design and ventila-tion of operating theatres (OTs) have been published, and threshold values have been proposed for both ultraclean and conventional theatres (1). Nevertheless, the levels of microbial air pollution in operating theatres still exceed recommended thresholds in many studies (2-4). In a recent contribution (3), a cor-relation was found between the level of microbial pollution and the number of people in the OTs and the number of door openings per hour. These results underline that it is essential to increase healthcare work-ers’ awareness of the risks associated with incorrect behaviours (5, 6). In some studies it has been observed that microbiological air pollution occurred also in empty OTs, showing the lack of adequate maintenance programmes for the ventilation systems (2, 7, 8). Therefore, in our view, investing only into healthcare workers training is not sufficient, in order to increase the safety of OTs. We support the idea that it is also crucial to increase attitudes and skills toward prevention of the Technical Offices’ staff, focusing both on undergraduates and on graduate workers, in order to properly prepare them. Indeed, working in multidisciplinary and multiprofessional teams requires the use of the same language and the ability to share both technical and sanitary skills. We are aware of precious initiatives in this direction managed through Master courses, like, for ex-ample, the one provided by the Politecnico di Milano (9), in which also two Schools of Medicine are involved, and some other intiatives promoted by professional associations. Effort to obtain a systematic cooperation between medical doctors, engineers and technicians, using the same language and devoted to a common goal, must be expanded to occur in all parts of the country. This is the only way to make available a sufficient amount of interdisciplinary expertise that can enhance overall preventive activities in all our healthcare services.Alessandro D’Amico*, Gaetano M Fara***Department of Civil, Building and Environmental Engineering, Sapienza University of Rome, Italy**Department of Public health and Infectious diseases, Sapienza University of Rome380 LetterReferences1. Pasquarella C, Vitali P, Saccani E, et al. Microbial air monitoring in operating theatres: experience at the University Hospital of Parma. J Hosp infect 2012; 81: 50-7.2. Pitzurra M, D’Alessandro D, Pasquarella C, et al. Survey of air conditioners’ characteristics and manage-ment in some Italian operating theatres. Ann Ig 1997; 9: 429-38.3. Agodi A, Auxilia F, Barchitta M, et al. Operating theatre ventilation systems and microbial air contamination in total joint replacement surgery: results of the GISIO-ISChIA study. J Hosp Infect 2015; 90: 213-9.4. D’Alessandro D, Fabiani M, Pallottino A, et al. Microbial pollution of operating rooms: critical analysis of two decades of surveillance. Ann Ig 2011; 23: 261-6.5. D’Alessandro D, Agodi A, Auxilia F, et al. Prevention of healthcare associated infections: medical and nursing students’ knowledge in Italy. Nurse Educ Today 2014; 34: 191e195.6. Agodi A, Auxilia F, Brusaferro S, et al. La formazione in tema di sicurezza delle cure e prevenzione e controllo delle infezioni correlate all’assistenza. Epidemiol Prev 2014; 38: 153-7.7. D’Alessandro D, Cerquetani F, Deriu MG, et al. Evaluation of fungal contamination in operating rooms using a dusting cloth pad: comparison among different sampling methods. Am J Infect control 2013; 41: 658-60.8. Vescia N, Brenier-Pinchart MP, Osborn JF, et al. Field validation of a dusting cloth for mycological sur-veillance of surfaces. Am J Infect Control 2011; 39: 156-8.9. Second level University Master in “Planning, programming and design of hospital and other healthcare systems”, 7th Edition 2016-2017, c/o Politecnico di Milano, Università degli Studi di Milano, Facoltà di Medicina ed Università Cattolica del Sacro Cuore, Facoltà di Medicina. Available from: www.polimi.it/index.php?id=5782&uid=3518 [Last accessed 2016, October 18].

The need to develop a multidisciplinary expertise for the microbiological safety of operating theatres

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The need to develop a multidisciplinary expertise for the microbiological safety of operating theatres

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