Investigation the Role of Various Antiseptics on the Prevalence of Skin Microbiota and Post Cesarean Surgery Infections
Keywords:postoperative infection, antiseptics, skin microbiota, VITEK-2 system
During this study, 690 swabs were taken from different sites divided as the following: First, 350 swabs from surgical instruments, doctor gloves, and antiseptics before beginning cesarean surgery to ensure their sterilization. Second, 310 swabs from 70 skins (out of 100) of female patients attending Al-Elwiya Educational Maternity Hospital were taken at the site of cesarean surgery incision before and after sterilization with 10% povidone-iodine and 10% povidone-iodine mixed with 70% ethanol to detect the efficiency of antiseptics and any bacterial invasion might cause post operative infections. Furthermore, 30 swabs from infected surgical sites were taken from 30 female patients with post operative cesarean infections to detect the causative bacterial pathogen. The result of 350 swabs that were all taken from different surgical instruments, doctor gloves, and antiseptics before surgery in all groups showed negative growth culture. The bacterial isolates were primary identified by phenotypic examinations and biochemical tests and final identification by VITEK -2 system. Staphylococcus epidermidis was revealed to be the prevalent bacterial species from all skin sample sources, while Staphylococcus aureus was dominant in surgical site infections. Sterilization with 10% povidone iodine mixed with 70% ethanol showed less bacterial load on skin with a significant decrease in the numbers of isolated bacteria in comparison to use 10% povidone iodine solution alone.
R. Nashibi, A. Khosravi, E. Bakhtiary, and M. Shiravi, "Evaluation of risk factors and the epidemiological pattern of nosocomial infection after gynaecological surgery in Ahvaz Imam Khomeini Hospital during the period 2011-2016," Medical Studies/Studia Medyczne, vol. 36, no. 1, pp. 26-30, 2020.
R. A. Borchardt and D. Tzizik, "Update on surgical site infections: the new CDC guidelines," Journal of the American Academy of Pas, vol. 31, no. 4, pp. 52-54, 2018.
T. C. Horan, R. P. Gaynes, W. J. Martone, W. R. Jarvis, and T. G. Emori, "CDC definitions of nosocomial surgical site infections, 1992: a modification of CDC definitions of surgical wound infections," Infection Control & Hospital Epidemiology, vol. 13, no. 10, pp. 606-608, 1992.
M. A. Haque, M. M. M. Begum, M. A. Sayem, and H. Hasan, "Management of Surgical Site Infection," East African Scholars J Med Surg, vol. 3, no. 4, pp. 70-76, 2021.
C. Pasquarella, C. Balocco, M. E. Colucci, E. Saccani, S. Paroni, L. Albertini, P. Vitali, and R. Albertini, "The influence of surgical staff behavior on air quality in a conventionally ventilated operating theatre during a simulated arthroplasty: a case study at the University Hospital of Parma," International Journal of Environmental Research and Public Health, vol. 17, no. 2, p. 452, 2020.
R. V. Patel, D. J. Shani, P. T. Shah, and D. Pandey, "Caesarean section in a tertiary care centre," International Journal of Reproduction, Contraception, Obstetrics and Gynecology, vol. 9, no. 8, pp. 3106-3112, 2020.
R. Coico, Immunology: a short course. John Wiley & Sons, 2021.
A. Ahmad, M. Saeed, S. Hussain, M. Ahmad, A. Tahir, and F. Rasheed, "Bacteriological Spectrum of Surgical Wound Infections," Annals of PIMS ISSN, vol. 1815, p. 2287, 2016.
W. Ng, D. Alexander, B. Kerr, M. Ho, M. Amato, and K. Katz, "A hairy tale: successful patient education strategies to reduce prehospital hair removal by patients undergoing elective caesarean section," Journal of Hospital Infection, vol. 83, no. 1, pp. 64-67, 2013.
S. Jolivet and J.-C. Lucet, "Surgical field and skin preparation," Orthopaedics & Traumatology: Surgery & Research, vol. 105, no. 1, pp. S1-S6, 2019.
P. W. Lundberg, A. A. Smith, J. B. Heaney, W. C. Wimley, A. T. Hauch, R. L. Nichols, and J. R. Korndorffer, "Pre-operative antisepsis protocol compliance and the effect on bacterial load reduction," Surgical infections, vol. 17, no. 1, pp. 32-37, 2016.
W. H. Organization, "Decontamination and reprocessing of medical devices for health-care facilities: aide-memoire," World Health Organization, 2022.
P. Southworth, "Infections and exposures: reported incidents associated with unsuccessful decontamination of reusable surgical instruments," Journal of Hospital Infection, vol. 88, no. 3, pp. 127-131, 2014.
M. J. Alfa, "Biofilms on instruments and environmental surfaces: Do they interfere with instrument reprocessing and surface disinfection? Review of the literature," American Journal of Infection Control, vol. 47, pp. A39-A45, 2019.
T. L. Wiemken, "Skin antiseptics in healthcare facilities: is a targeted approach necessary?," BMC Public Health, vol. 19, no. 1, pp. 1-4, 2019.
S. Rattanakanokchai, N. Eamudomkarn, N. Jampathong, B.-Y. Luong-Thanh, and C. Kietpeerakool, "Changing gloves during cesarean section for prevention of postoperative infections: a systematic review and meta-analysis," Scientific reports, vol. 11, no. 1, pp. 1-10, 2021.
T. C. Scharschmidt, "Establishing tolerance to commensal skin bacteria: timing is everything," Dermatologic clinics, vol. 35, no. 1, pp. 1-9, 2017.
K. M. Rood, I. A. Buhimschi, J. A. Jurcisek, T. L. Summerfield, G. Zhao, W. E. Ackerman, W.Wang, R. W. Rumpf, S. F. Thung, and L. O. Bakaletz, "Skin microbiota in obese women at risk for surgical site infection after cesarean delivery," Scientific reports, vol. 8, no. 1, pp. 1-8, 2018.
D. Dörfel, M. Maiwald, G. Daeschlein, G. Muller, R. Hudek, O. Assadian, G. Kampf, T. Kohlmann, J. C. Harnoss, and A. Kramer, "Comparison of the antimicrobial efficacy of povidone-iodine-alcohol versus chlorhexidine-alcohol for surgical skin preparation on the aerobic and anaerobic skin flora of the shoulder region," Antimicrobial Resistance & Infection Control, vol. 10, no. 1, pp. 1-9, 2021.
K. C. Mascarello, B. L. Horta, and M. F. Silveira, "Maternal complications and cesarean section without indication: systematic review and meta-analysis," Revista de saude publica, vol. 51, 2017.
J. N. O'Sullivan, M. C. Rea, P. M. O'Connor, C. Hill, and R. P. Ross, "Human skin microbiota is a rich source of bacteriocin-producing staphylococci that kill human pathogens," FEMS Microbiology Ecology, vol. 95, no. 2, p. fiy241, 2019.
J. Delmas, J. P. Chacornac, F. Robin, P. Giammarinaro, R. Talon, and R. Bonnet, "Evaluation of the Vitek 2 system with a variety of Staphylococcus species," Journal of clinical microbiology, vol. 46, no. 1, pp. 311-313, 2008.
W. Zhou, M. Spoto, R. Hardy, c. Guan, E. Fleming, P. J. Larson, J. S. Broun, and J. Oh, "Host-specific evolutionary and transmission dynamics shape the functional diversification of Staphylococcus epidermidis in human skin," Cell, vol. 180, no. 3, pp. 454-470. e18, 2020.
E. Presterl, M. Suchomel, M. Eder, S. Reichmann, A. Lassnigg, W. Graninger, and M. Rotter, "Effects of alcohols, povidone-iodine and hydrogen peroxide on biofilms of Staphylococcus epidermidis," Journal of Antimicrobial Chemotherapy, vol. 60, no. 2, pp. 417-420, 2007.
A. Kameli, H. Raoufian, R. Besharati, D. Akhlaghi, R. Azizi, and S. Gholami, "The Comparative Effects of Surgical Scrub with Alcohol Based Solutions and Povidone-Iodine on the Growth of the Bacterial Contamination of Hands Over Time: A Randomized Crossover Study," Journal of North Khorasan University of Medical Sciences, vol. 12, no. 3, pp. 56-61, 2020.
H. O. Eltwisy, H. O. Twisy, M. H. Hafez, I. M. Sayed, and M. A. El-Mokhtar, "Clinical infections, antibiotic resistance, and pathogenesis of Staphylococcus haemolyticus," Microorganisms, vol. 10, no. 6, p. 1130, 2022.
S. Parthasarathy, S. Shah, A. R. Sager, A. Rangan, and S. Durugu, "Staphylococcus lugdunensis: review of epidemiology, complications, and treatment," Cureus, vol. 12, no. 6, 2020.
D. M. Haas, S. Morgan, K. Contreras, and S. Kimball, "Vaginal preparation with antiseptic solution before cesarean section for preventing postoperative infections," Cochrane Database of Systematic Reviews, no. 4, 2020.
K. Findley and E. A. Grice, "The skin microbiome: a focus on pathogens and their association with skin disease," Plos pathogens, vol. 10, no. 11, p. e1004436, 2014.
T. Hirsch, H.-M. Seipp, F. Jacobsen, O. Goertz, H.-U. Steinau, and L. Steinstraesser, "Antiseptics in surgery," Eplasty, vol. 10, 2010.
How to Cite
Copyright (c) 2023 Al-Mustansiriyah Journal of Science
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Articles accepted for publication in Al-Mustansiriyah Journal of Science (MJS) are protected under the Creative Commons Attribution 4.0 International License (CC BY-NC). Authors of accepted articles are requested to sign a copyright release form prior to their article being published. All authors must agree to the submission, sign copyright release forms, and agree to be included in any correspondence between MJS and the authors before submitting a work to MJS. For personal or educational use, permission is given without charge to print or create digital copies of all or portions of a MJS article. However, copies must not be produced or distributed for monetary gain. It is necessary to respect the copyright of any parts of this work that are not owned by MJS.