Microbiological surveillance of various sterilization parameters in ophthalmic operation theatre at a tertiary centre of south India
Journal Title: Medpulse International Journal of Ophthalmology - Year 2019, Vol 9, Issue 3
Abstract
Background: Post-surgical infective endophthalmitis is a nightmare for every Ophthalmologist. It is rightly placed as the most dreaded and unpredictable complication. So, an equal importance is given to sterility of the operation theatre. The environment inside the theatre is dynamic and continuously changing. Good infrastructure does not imply safe environment as number of humans and their mobility affect it. The air and equipments inside an operating theatre may harbor a diverse array of micro-organisms. In this retrospective study we analyzed the microbiological surveillance records of our operation theatre of last 2 years from Jan 2017 to Jan 2019 for the sources of contamination, organisms we encountered and the remedial measures we took to improve efficiency of various disinfection methods, handling of instruments, testing of OT staff for carriage and amendments to the standard operating protocol (SOP) of the operation theatre staff. Materials and Methods: The present study was a retrospective analysis of microbiological surveillance of major Ophthalmic theatre and theatre personnel. In the major operating room, sampling was conducted 104 times over 2 years. After fumigation with formaldehyde, before the starting of the next surgical procedure, sealing of the room was done for 24 hours.Monthly assessment of Environmental Bacteria Carrying Particle (BCP) load / bio load was done by sedimentation method prior to the commencement of the surgeries. In the surgical operating room, swabs were collected from the surfaces of the representative areas. Results: On total 5 occasions (4.80%) theatre environment was having risk for airborne infection. (High bacterial count on 4 occasions (3.84%) and presence of S. aureus on 1 occasion (0.96%).) Clostridium species was not detected in any sample. AC filter was positive for fungus on one occasion and autoclave sterilization was found to be unsatisfactory on 2 occasions. Remedial measures were instituted. Conclusion: There is high need for the routine microbiological surveillance of Ophthalmic operating rooms to minimize the risk of development of exogenous post-surgical infections.
Authors and Affiliations
P S Giridhar, Harshila Jain, Manjunath Natarajan, Prakash S, G Dhanalakshmi
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