Skin bacteria and surgical infections.

• Research type

  Research Study

• Full title

  Skin bacteria as a source of surgical infections: molecular epidemiology and prevention of wound contaimination

• IRAS ID

  35925

• Contact name

  Sheila Patrick

• Sponsor organisation

  Belfast Health & Social Care Trust

• Eudract number

  2009-016566-82

• ISRCTN Number

  N/A

• Clinicaltrials.gov Identifier

  N/A

• Research summary

  A recent study of spinal surgery at Queen's University, Belfast showed that nearly 30% of operative wounds contained bacteria of the normal skin microbiota, despite pre-operative treatment of the patient's skin with the antiseptic povidone-iodine (PVI); however, as pre-operative antibiotic prophylaxis was successful these patients did not have post-surgical infection. The rise in antibiotic resistance, typified by methicillin resistant Staphylococcus aureus (MRSA), will inevitably result in an increase in life threatening post-surgical infection, potentially to the 30% level of wound contamination observed in the QUB study. It is therefore proposed to pre-empt such a scenario by addressing the current procedures for skin antisepsis prior to surgery. PVI and chlorhexidine gluconate (CHG) are skin disinfection antiseptics with different modes of bacterial killing; however, there have been no randomised controlled trials to determine if CHG used in addition to PVI reduces wound contamination in the operative setting. It is therefore proposed to determine if the sequential pre-operative treatment of patient's skin with the antiseptics PVI and CHG will reduce wound contamination in a randomised controlled trial of patients undergoing orthopaedic surgery. Wound contamination will be determined by total viable bacterial counts and bacteria will be tracked using methods such as Multilocus Sequence Typing. The antibiotic and antiseptic resistance of isolates will be determined, as will the presence of key antibiotic resistance genes. This study will enable us to determine if by using both PVI and CHG it will be possible to counter the potential rise in post-operative infection arising from antibiotic resistant bacteria.

• REC name

  HSC REC B

• REC reference

  09/NIR03/79

• Date of REC Opinion

  24 Dec 2009

• REC opinion

  Further Information Favourable Opinion