Many Common Pathogens are Present in the Operative Room Air During Surgery

J Arthroplasty. 2022 Dec;37(12):2427-2430. doi: 10.1016/j.arth.2022.07.007. Epub 2022 Jul 16.


Background: The main objective of this study was to assess the sanitary measures of operating theaters using next-generation sequencing.

Methods: Air was sampled from the operating room for the whole duration of 10 surgical days of "clean" (no infection cases) procedures (6 hip/knee arthroplasty and 4 spine cases). Controls consisted of samples at the beginning of the day (1 hour before the surgery started) and at the end of the day after terminal cleaning. One additional control sample, consisting of a culture swab that was opened and exposed to the air for 5 seconds, was collected at each time point. All samples were sent for next-generation sequencing analysis (16S rRNA sequencing) for bacterial identification.

Results: Overall, 306 samples were collected (159 controls and 147 experimental). Microbial DNA was detected in only 1 control sample, while 18 (12.2%) experimental samples were positive for microbial DNA. The most common organisms retrieved were Escherichia coli (6/18, 30%), Cutibacterium acnes (3/18, 15%), and Pseudomonas aeruginosa (2/18, 11.1%). There was no difference in positive samples between arthroplasty and spine cases (P > .05).

Conclusion: Microbial organisms are not uncommonly present in the operating room air during hip and knee arthroplasties and spine procedures.

Keywords: hip; knee; next-generation sequencing; operating room; pathogens; spine.

MeSH terms

  • Arthroplasty, Replacement, Knee*
  • Humans
  • Knee Joint
  • Operating Rooms
  • RNA, Ribosomal, 16S / genetics


  • RNA, Ribosomal, 16S