Operating theaters are not all the same: can downflow ultra clean air really make a difference? A correlation study between HVAC systems and surgical site infections.

IF 3.1 3区医学 Q1 INFECTIOUS DISEASES

Journal of Hospital Infection Pub Date : 2025-10-09 DOI:10.1016/j.jhin.2025.08.016

Jacopo Dolcini, Agnese Lucesoli, Giorgio Firmani, Roberto Allegrezza Giulietti, Roberto Bruschi, Enrica Martini, Maria Grazia Gioia, Marcello Mario D'Errico, Pamela Barbadoro

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引用次数: 0

Abstract

Background: Air quality in operating theaters (OTs) is crucial for preventing surgical site infections (SSIs). HVAC systems should ensure high air quality, minimizing microbial contamination. Recently, the effectiveness of downflow ultra-clean air (UCA) systems in preventing SSIs has been debated.

Aim: This study analyzes the correlation between OT HVAC systems and SSI incidence using data from 12 hospitals in the Marche Region (2018-2019).

Methods: The data were correlated with the incidence of SSIs following 899 surgical procedures. A logistic regression analysis showed that UCA systems were associated with a reduced risk of SSI (OR=0.37; C.I. 0.15-0.92).

Findings: We observed 38 SSIs, resulting in a total incidence of 4.2% (95% C.I. 3.0-5.8). Of these, 29 occurred under non-UCA systems (5.17%, 95% C.I. 3.5-7.4), and 9 occurred in UCA environments (2.66%, 95% C.I. 1.2-5.0). Technical data were collected from validation tests in each OT, focusing on UCA HVAC systems with unidirectional airflow meeting ISO 5 class standards.

Conclusions: These data suggest the potential effectiveness of UCA in reducing microbial air contamination, thus improving air quality and decreasing the risk of SSIs compared to non-UCA ventilation systems.

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手术室并不都是一样的：向下流动的超洁净空气真的能起作用吗？暖通空调系统与手术部位感染的相关性研究。

背景：手术室空气质量对预防手术部位感染至关重要。暖通空调系统应确保高空气质量，尽量减少微生物污染。最近，下流超洁净空气（UCA）系统在预防ssi方面的有效性一直存在争议。目的：本研究利用马尔凯地区12家医院（2018-2019）的数据，分析OT HVAC系统与SSI发病率之间的相关性。方法：分析899例外科手术后ssi的发生率。逻辑回归分析显示，UCA系统与SSI风险降低相关（OR=0.37; ci = 0.15-0.92）。结果：我们观察到38例ssi，总发生率为4.2% （95% ci 3.0-5.8）。其中29例发生在非UCA环境下（5.17%,95% C.I. 3.5-7.4）， 9例发生在UCA环境下（2.66%,95% C.I. 1.2-5.0）。从每个OT的验证测试中收集技术数据，重点是具有单向气流的UCA HVAC系统符合ISO 5级标准。结论：这些数据表明，与非UCA通风系统相比，UCA在减少微生物空气污染方面具有潜在的有效性，从而改善空气质量并降低ssi的风险。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Hospital Infection 医学-传染病学

CiteScore

12.70

自引率

5.80%

发文量

271

审稿时长

19 days

期刊介绍： The Journal of Hospital Infection is the editorially independent scientific publication of the Healthcare Infection Society. The aim of the Journal is to publish high quality research and information relating to infection prevention and control that is relevant to an international audience. The Journal welcomes submissions that relate to all aspects of infection prevention and control in healthcare settings. This includes submissions that: provide new insight into the epidemiology, surveillance, or prevention and control of healthcare-associated infections and antimicrobial resistance in healthcare settings; provide new insight into cleaning, disinfection and decontamination; provide new insight into the design of healthcare premises; describe novel aspects of outbreaks of infection; throw light on techniques for effective antimicrobial stewardship; describe novel techniques (laboratory-based or point of care) for the detection of infection or antimicrobial resistance in the healthcare setting, particularly if these can be used to facilitate infection prevention and control; improve understanding of the motivations of safe healthcare behaviour, or describe techniques for achieving behavioural and cultural change; improve understanding of the use of IT systems in infection surveillance and prevention and control.