New study confirms nose is key source of infection

Findings include 86% of surgical site infections ("SSIs") caused by bacteria from the patients' own nose, skin, or gut and nearly 60% of infections are resistant to antibiotics

Ondine Biomedical Inc. (LON: OBI), the Canadian life sciences company pioneering light-activated antimicrobial treatments, announces new independent research published in the journal Science Translational Medicine showing that 86% of surgical site infections (SSIs)! after spinal surgery are caused by bacteria from the patient's own nose, skin, or gut. The study, "Contribution of the patient microbiome to surgical site infection and antibiotic prophylaxis failure in spine surgery", was undertaken by researchers from the University of Washington School of Medicine in Seattle and reinforces the findings of previous studies that have shown that nasal and skin decolonization result in significantly lower rates of SSIs.

Over a 12-month period, the University of Washington researchers sampled bacteria living in the nose, skin and stool of over 200 patients prior to spine surgery. There was then a follow-up at 90 days to compare those samples with any post-surgical infections that occurred. The study showed that 86% of the bacteria causing infections after spine surgery were genetically matched to bacteria the patient carried before surgery. Researchers also discovered that bacteria colonizing the upper back around the neck and shoulders are more similar to those found in the nose, and those normally colonizing the lower back are more similar to those found in the gut and stool.

Another key finding of the study was that 59% of infections were resistant to the antibiotic used to prevent surgical site infections (SSIs), the antiseptic used to clean the skin before surgery, or both. Rising rates of resistant bacteria pose a fundamental threat to the safety of all types of surgery. There were an estimated 1.27 million deaths attributable to bacterial antimicrobial resistance (AMR) in 2019, and the two pathogens associated with the most AMR-related deaths - Escherichia coli and Staphylococcus aureus - are also the cause of most post-operative infections.[1]

SSIs are serious complications that can occur following surgery, and are the most common type of healthcare-associated infection (HAI). Spine SSIs can affect up to 18% of patients who then require long, complex and costly treatment.[2] Nasal decolonization is now deemed an essential practice prior to major surgeries, including spine and cardiac surgery, by the Society for Healthcare Epidemiology of America (SHEA).[3] SSIs involving drug-resistant pathogens are associated with significantly increased length of hospitalization and costs.[4]

Lead authors Dustin Long, Assistant Professor of Anesthesiology, School of Medicine, University of Washington and Chloe Bryson-Cahn, Associate Professor of Allergy and Infectious Diseases, School of Medicine, University of Washington, commented: "Surgical site infections occur following about one in 30 procedures, typically with no explanation. While rates of many other medical complications have shown steady improvement over time, data from the Agency for Healthcare Research and Quality and the Centers for Disease Control and Prevention show that the problem of surgical site infection is not getting better."

The University of Washington research demonstrates the benefits of focusing on novel solutions for nasal decolonization like Ondine Biomedical's light-activated antimicrobial, Steriwave®. Unlike traditional antibiotics, Steriwave is immediately effective with a single five-minute treatment and does not trigger antimicrobial resistance (AMR), making it an excellent alternative to the traditional antibiotics that many healthcare facilities use to prevent HAIs.

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[1] Murray CJ, Ikuta KS, Sharara F, Swetschinski L, Robles Aguilar G, Gray A et al. Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis. Lancet 2022;399:629-655.

[2] Chahoud J, Kanafani Z, Kanj SS. Surgical site infections following spine surgery: eliminating the controversies in the diagnosis. Front Med (Lausanne). 2014 Mar 24;1:7. doi: 10.3389/fmed.2014.00007.

[4] Weigelt JA, Lipsky BA, Tabak YP, Derby KG, Kim M, Gupta V (2010) Surgical site infections: causative pathogens and associated outcomes. Am J Infect Control 38:112-120. https://doi.org/10.1016/j.ajic.2009.06.010