Rising Antimicrobial Resistance and the Role of the Patient Microbiome

Rising Antimicrobial Resistance and the Role of the Patient Microbiome

By: Alexandra de Leon Date: June 17th, 2022

One of the most frequent complications of modern surgery is healthcare-associated infection. Researchers at the University of Washington and University of Chicago have published a new review focused on the prevention of surgical site infections.

The team set out to look at two paradigms connected to these infections. The first was the role of patient microbiome in surgical site infections. Researchers pointed out germ theory, modern hospital sanitation measures, and advances in operating room sterility have led to substantial declines in perioperative infections over the past centuries, but there are additional ways the surgical site may become infected.

“We now are learning that a patient’s own microbiome may contribute significantly to surgical site infection through a variety of mechanisms. This can be through direct contamination, but may also occur through remote ‘seeding’ of the surgical site from anatomically distant compartments of the human microbiome,” says lead author Dr. Dustin R. Long, Assistant Professor in the Division of Critical Care Medicine in the Department of Anesthesiology and Pain Medicine at the University of Washington School of Medicine.

The authors also review the potential impact of antibiotic resistance on surgical infections, pointing out that sociodemographic factors are among the strongest forces influencing the microbiome.

“The global burden of antimicrobial resistance continues to expand beyond the confines of the healthcare system, into our communities,” says Dr. Long.  “The anticipated impact of these trends on the efficacy of routine surgical antibiotic prophylaxis is concerning. Microbiome- and resistance-driven disparities in surgical outcomes are likely to develop, or may already exist within the US healthcare system.”

The authors suggest that tailored approaches targeting the individual patient microbiome hold promise in balancing antimicrobial stewardship with efficacy and achieving improved outcomes in diverse surgical populations.

Funding for this study was provided by the National Institutes of Health Mentored Patient-Oriented Research Career Development Award from the National Institute of Arthritis and Musculoskeletal and Skin Diseases.

The review was published in Anesthesiology (pubs.asahq.org).

Illustrated Figures explaining Patient Microbiome and Antimicrobial Resistance