319. Modular and Deployed Operating Room Contamination Rates
Session: Poster Abstract Session: Assessing and Reducing Infection Risk
Friday, October 21, 2011
Room: Poster Hall B1
Background: Disaster and military medicine necessitates establishment of deployed operating rooms (ORs) to manage patients with traumatic injuries. During the wars in Iraq and Afghanistan and in natural disasters around the world, patients with traumatic injuries have developed infections with multidrug-resistant (MDR) bacteria. Studies have supported nosocomial transmission of these MDR bacteria, including the possibility of environmental OR contamination. In this study we review the environmental contamination of deployed and modular ORs.

Methods: Swabs were used to screen 14 surfaces for contamination of a US modular field expedient OR prior to opening and 5 weeks into its use in parallel to screening of an OR within the co-located US based hospital. Swabs of an Afghanistan theater hospital OR were evaluated for surface contamination of 11 surfaces. For aerosolization of gram negative rods within a fixed facility OR in Iraq, settle plates were evaluated during 21 surgical procedures and 21 periods without surgery.

Results:  In the US modular OR, prior to initial patient surgeries, 2 surfaces were colonized with coagulase negative Staphylococcus (CNS), 1 with Bacillus species and 1 with a fungi. The fixed US OR had 4 surfaces with CNS. At follow up 5 weeks into using the ORs for surgery, 2 surfaces were colonized in the modular OR with CNS and 4 fixed facility OR surfaces were colonized with CNS.  The OR evaluation in Afghanistan revealed 1 surface with a Micrococcus letueus. For evaluation of aerosolization, in a fixed OR in Iraq with and without surgery, the mean colony count was 12.8 CFU/dm2/h (standard deviation (SD),17.0) during surgeries and 6.5 CFU/dm2/h (SD, 7.5) (p=0.14) when the OR was not in use.  Excluding the 3 burn patient undergoing surgical debridement, the mean settle plates were 8.6 CFU/dm2/h with a SD of 8.9.

Conclusion: Standard infection control cleaning procedures in a modular OR in the US or overseas appear adequate to minimize contamination with no differences in aerosolization between OR rooms that were actively being used versus not.


Subject Category: N. Hospital-acquired and surgical infections, infection control, and health outcomes including general public health and health services research

Clinton K. Murray, MD1, Timothy Wallum, MS2, Charles Guymon, MA2, Heather Yun, MD1, Helen Crouch, RN, MPH, CIC1, Matthew Griffith, MD1, Bernadette Thompson, RN, BSN, CIC1, Katrin Mende, PhD3 and Duane Hospenthal, MD, PhD4, (1)San Antonio Military Medical Center, Fort Sam Houston, TX, (2)US Army Institute of Surgical Research, Fort Sam Houston, TX, (3)Infectious Disease Clinical Research Program, Fort Sam Houston, TX, (4)San Antonio Military Medical Center, MCHE MDI 7 East, TX

Disclosures:

C. K. Murray, None

T. Wallum, None

C. Guymon, None

H. Yun, None

H. Crouch, None

M. Griffith, None

B. Thompson, None

K. Mende, None

D. Hospenthal, None

Findings in the abstracts are embargoed until 12:01 a.m. EST Thursday, Oct. 20 with the exception of research findings presented at IDSA press conferences.