Antimicrobial Resistance Collaborators. Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis. Lancet 2022; 399: 629–55. https://doi.org/10.1016/s0140-6736(21)02724-0

Article  CAS  Google Scholar 

Boucher HW, Talbot GH, Bradley JS, et al. Bad bugs, no drugs: no ESKAPE! An update from the Infectious Diseases Society of America. Clin Infect Dis 2009; 48: 1–12. https://doi.org/10.1086/595011

Article  PubMed  Google Scholar 

Loftus RW, Dexter F, Brown JR. Transmission of Staphylococcus aureus in the anaesthesia work area has greater risk of association with development of surgical site infection when resistant to the prophylactic antibiotic administered for surgery. J Hosp Infect 2023; 134: 121–8. https://doi.org/10.1016/j.jhin.2023.01.007

Article  CAS  PubMed  Google Scholar 

Menzel J, Kühn A, Beck D, Schock B, Chaberny IF. Hand hygiene in the operating room (OR)-(not) an issue? [German]. Unfallchirurgie (Heidelb) 2023; 126: 563–8. https://doi.org/10.1007/s00113-022-01181-0

Article  PubMed  Google Scholar 

Dexter F, Loftus RW. Estimation of the contribution to intraoperative pathogen transmission from bacterial contamination of patient nose, patient groin and axilla, anesthesia practitioners' hands, anesthesia machine, and intravenous lumen. J Clin Anesth 2024; 92: 111303. https://doi.org/10.1016/j.jclinane.2023.111303

Article  CAS  PubMed  Google Scholar 

Loftus RW, Dexter F, Robinson AD. High-risk Staphylococcus aureus transmission in the operating room: a call for widespread improvements in perioperative hand hygiene and patient decolonization practices. Am J Infect Control 2018; 46: 1134–41. https://doi.org/10.1016/j.ajic.2018.04.211

Article  PubMed  Google Scholar 

Loftus RW, Dexter F, Robinson AD, Horswill AR. Desiccation tolerance is associated with Staphylococcus aureus hypertransmissibility, resistance and infection development in the operating room. J Hosp Infect 2018; 100: 299–308. https://doi.org/10.1016/j.jhin.2018.06.020

Article  CAS  PubMed  Google Scholar 

Jian Y, Zhao L, Zhao N, et al. Increasing prevalence of hypervirulent ST5 methicillin susceptible Staphylococcus aureus subtype poses a serious clinical threat. Emerg Microbes Infect 2021; 10: 109–22. https://doi.org/10.1080/22221751.2020.1868950

Article  CAS  PubMed  PubMed Central  Google Scholar 

Zhong L, Men TY, Li H, et al. Multidrug-resistant gram-negative bacterial infections after liver transplantation—spectrum and risk factors. J Infect 2012; 64: 299–310. https://doi.org/10.1016/j.jinf.2011.12.005

Article  PubMed  Google Scholar 

Chea N, Sapiano MR, Zhou L, et al. Rates and causative pathogens of surgical site infections attributed to liver transplant procedures and other hepatic, biliary, or pancreatic procedures, 2015–2018. Transpl Infect Dis 2021; 23: e13589. https://doi.org/10.1111/tid.13589

Article  CAS  PubMed  PubMed Central  Google Scholar 

Dexter F, Loftus RW. Retrospective cohort study of anaesthesia machines shows low bacterial contamination can be achieved with surface disinfection. Br J Anaesth 2023; 131: e109–11. https://doi.org/10.1016/j.bja.2023.07.016

Article  PubMed  Google Scholar 

Ochoa SA, Cruz-Córdova A, Mancilla-Rojano J, et al. Control of methicillin-resistant Staphylococcus aureus strains associated with a hospital outbreak involving contamination from anesthesia equipment using UV-C. Front Microbiol 2020; 11: 600093. https://doi.org/10.3389/fmicb.2020.600093

Article  PubMed  PubMed Central  Google Scholar 

Loftus RW, Dexter F, Robinson AD. Methicillin-resistant Staphylococcus aureus has greater risk of transmission in the operating room than methicillin-sensitive S. aureus. Am J Infect Control 2018; 46: 520–5. https://doi.org/10.1016/j.ajic.2017.11.002

Article  PubMed  Google Scholar 

Clark C, Taenzer A, Charette K, Whitty M. Decreasing contamination of the anesthesia environment. Am J Infect Control 2014; 42: 1223–5. https://doi.org/10.1016/j.ajic.2014.07.016

Article  PubMed  Google Scholar 

Loftus RW, Koff MD, Burchman CC, et al. Transmission of pathogenic bacterial organisms in the anesthesia work area. Anesthesiology 2008; 109: 399–407. https://doi.org/10.1097/aln.0b013e318182c855

Article  PubMed  Google Scholar 

Loftus RW, Brown JR, Koff MD, et al. Multiple reservoirs contribute to intraoperative bacterial transmission. Anesth Analg 2012; 114: 1236–48. https://doi.org/10.1213/ane.0b013e31824970a2

Article  PubMed  Google Scholar 

Loftus RW, Dexter F, Goodheart MJ, et al. The effect of improving basic preventive measures in the perioperative arena on Staphylococcus aureus transmission and surgical site infections, a randomized clinical trial. JAMA Netw Open 2020; 3: e201934. https://doi.org/10.1001/jamanetworkopen.2020.1934

Article  PubMed  Google Scholar 

Wall RT, Datta S, Dexter F, et al. Effectiveness and feasibility of an evidence-based intraoperative infection control program targeting improved basic measures; a post-implementation prospective case-cohort study. J Clin Anesth 2022; 77: 110632. https://doi.org/10.1016/j.jclinane.2021.110632

Article  PubMed  Google Scholar 

Spertini V, Borsoi L, Berger J, Blacky A, Dieb-Elschahawi M, Assadian O. Bacterial contamination of anesthesia machines' internal breathing-circuit-systems. GMS Krankenhhyg Interdiszip 2011; 6: Doc14. https://doi.org/10.3205/dgkh000171

Biddle CJ, George-Gay B, Prasanna P, Hill EM, Davis TC, Verhulst B. Assessing a novel method to reduce anesthesia machine contamination: a prospective, observational trial. Can J Infect Dis Med Microbiol 2018; 2018: 1905360. https://doi.org/10.1155/2018/1905360

Article  PubMed  PubMed Central  Google Scholar 

Robinson AD, Dexter F, Renkor V, Reddy S, Loftus RW. Operating room PathTrac analysis of current intraoperative Staphylococcus aureus transmission dynamics. Am J Infect Control 2019; 47: 1240–7. https://doi.org/10.1016/j.ajic.2019.03.028

Article  PubMed  Google Scholar 

Dexter F, Epstein RH, Gostine AL, Penning DH, Loftus RW. Benefit of systematic selection of pairs of cases matched by surgical specialty for surveillance of bacterial transmission in operating rooms. Am J Infect Control 2020; 48: 682–7. https://doi.org/10.1016/j.ajic.2019.09.025

Article  PubMed  Google Scholar 

Datta S, Dexter F, Ledolter J, Wall RT, Loftus RW. Sample times for surveillance of S. aureus transmission to monitor effectiveness and provide feedback on intraoperative infection control. Perioper Care Oper Room Manag 2020; 21: 100137. https://doi.org/10.1016/j.pcorm.2020.100137

Article  PubMed  PubMed Central  Google Scholar 

Zuckerman JB, Zuaro DE, Prato BS, et al. Bacterial contamination of cystic fibrosis clinics. J Cyst Fibro 2009; 8: 186–92. https://doi.org/10.1016/j.jcf.2009.01.003

Article  Google Scholar 

Loftus RW, Muffly MK, Brown JR, et al. Hand contamination of anesthesia providers is an important risk factor for intraoperative bacterial transmission. Anesth Analg 2011; 112: 98–105. https://doi.org/10.1213/ane.0b013e3181e7ce18

Article  PubMed  Google Scholar 

Charnin JE, Griffiths SA, Loftus CP, Dexter F, Loftus RW. Bacterial contamination of syringe tips after anaesthesia care with use of disinfectable needleless closed connector devices. Br J Anaesth 2023; 131: e112–4. https://doi.org/10.1016/j.bja.2023.06.060

Article  PubMed  Google Scholar 

Larson EL, Strom MS, Evans CA. Analysis of three variables in sampling solutions used to assay bacteria of hands: type of solution, use of antiseptic neutralizers, and solution temperature. J Clin Microbiol 1980; 12: 355–60. https://doi.org/10.1128/jcm.12.3.355-360.1980

Article  CAS  PubMed  PubMed Central  Google Scholar 

Datta S, Dexter F, Suvarnakar A, Abi-Najm D, Wall RT, Loftus RW. Estimating costs of anesthesia supplies for intraoperative infection control. Am J Infect Control 2023; 51: 619–23. https://doi.org/10.1016/j.ajic.2022.07.028

Article  PubMed  Google Scholar 

Wilson AP, Smyth D, Moore G, et al. The impact of enhanced cleaning within the intensive care unit on contamination of the near-patient environment with hospital pathogens: a randomized crossover study in critical care units in two hospitals. Crit Care Med 2011; 39: 651–8. https://doi.org/10.1097/ccm.0b013e318206bc66

Article  PubMed  Google Scholar 

Dexter F, Brown JR, Wall RT, Loftus RW. The efficacy of multifaceted versus single anesthesia work area infection control measures and the importance of surgical site infection follow-up duration. J Clin Anesth 2023; 85: 111043. https://doi.org/10.1016/j.jclinane.2022.111043

Article  PubMed  Google Scholar 

Birnbach DJ, Rosen LF, Fitzpatrick M, Carling P, Arheart KL, Munoz-Price LS. Double gloves: a randomized trial to evaluate a simple strategy to reduce contamination in the operating room. Anesth Analg 2015; 120: 848–52. https://doi.org/10.1213/ane.0000000000000230

Article  PubMed  Google Scholar 

Dexter F, Parra MC, Brown JR, Loftus RW. Perioperative COVID-19 defense: an evidence-based approach for optimization of infection control and operating room management. Anesth Analg 2020; 131: 37–42. https://doi.org/10.1213/ane.0000000000004829

Article  CAS  PubMed  Google Scholar 

Dexter F, Marcon E, Aker J, Epstein RH. Numbers of simultaneous turnovers calculated from anesthesia or operating room information management system data. Anesth Analg 2009; 109: 900–5. https://doi.org/10.1213/ane.0b013e3181b08855

Article  PubMed  Google Scholar 

Goebel U, Gebele N, Ebner W, et al. Bacterial contamination of the anesthesia workplace and efficiency of routine cleaning procedures: a prospective cohort study. Anesth Analg 2016; 122: 1444–7. https://doi.org/10.1213/ane.0000000000001220

Article  PubMed  Google Scholar 

Schmidt E, Dexter F, Herrmann J, Godding JD, Hadder B, Loftus RW. Assessment of anesthesia machine redesign on cleaning of the anesthesia machine using surface disinfection wipes. Am J Infect Control 2020; 48: 675–81. https://doi.org/10.1016/j.ajic.2019.09.016

Article