Surgical site infections (SSIs) remain a major challenge in healthcare, and airborne microbial contamination represents a potential source of infection in operating theatres. This study investigated intraoperative airborne contamination through a multifactorial approach integrating conventional culture-based microbiological identification using MALDI-TOF MS, shotgun metagenomic Next Generation Sequencing (NGS), airborne particle monitoring and procedural factors. The research was conducted in two hospitals in Italy and Australia, involving 72 surgical procedures across general surgery, orthopaedics and urology. Air sampling was performed during surgical procedures, collecting 4,000 litres of air per procedure. Microbial identification was conducted using culture-based methods and MALDI-TOF MS, while metagenomic NGS was performed on samples collected at the Italian hospital. NGS revealed a broader microbial profile, including environmental taxa not detected through conventional culture-based methods. Higher airborne particle concentrations (≥0.5 µm and ≥5 µm) were associated with increased microbial contamination (CFU/m³). Staff presence was associated with more frequent door openings and increased particle levels, without a corresponding increase in microbial contamination. These findings highlight the complementary value of conventional and molecular microbiological methods and support the integration of microbiological, particulate and procedural monitoring to improve environmental contamination assessment and infection prevention strategies in operating theatres.
New insights into intraoperative airborne contamination in operating theatres: a multifactorial analysis integrating culture-based identification, metagenomic NGS, particle monitoring and procedural factors
Lanzoni L.;Antonioli P.;Campioni D.;Michilli A.;Bassi C.;Sabbioni S.;Zaffagnini T.;Cristino S.
2025
Abstract
Surgical site infections (SSIs) remain a major challenge in healthcare, and airborne microbial contamination represents a potential source of infection in operating theatres. This study investigated intraoperative airborne contamination through a multifactorial approach integrating conventional culture-based microbiological identification using MALDI-TOF MS, shotgun metagenomic Next Generation Sequencing (NGS), airborne particle monitoring and procedural factors. The research was conducted in two hospitals in Italy and Australia, involving 72 surgical procedures across general surgery, orthopaedics and urology. Air sampling was performed during surgical procedures, collecting 4,000 litres of air per procedure. Microbial identification was conducted using culture-based methods and MALDI-TOF MS, while metagenomic NGS was performed on samples collected at the Italian hospital. NGS revealed a broader microbial profile, including environmental taxa not detected through conventional culture-based methods. Higher airborne particle concentrations (≥0.5 µm and ≥5 µm) were associated with increased microbial contamination (CFU/m³). Staff presence was associated with more frequent door openings and increased particle levels, without a corresponding increase in microbial contamination. These findings highlight the complementary value of conventional and molecular microbiological methods and support the integration of microbiological, particulate and procedural monitoring to improve environmental contamination assessment and infection prevention strategies in operating theatres.I documenti in SFERA sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
