Nasal Microbiota and Infectious Complications after Elective
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These JAMA Network study findings suggest that the nasal microbiome is an independent risk factor associated with infectious outcomes after elective surgical procedures.

The study objective was to characterize the composition of the nasal microbiota in patients undergoing clean elective surgical procedures and to examine the association between characteristics of preoperative nasal microbiota and occurrence of postoperative infection.

Using a nested matched case-control design, 53 individuals who developed postoperative infection were matched with 144 individuals who were not infected. The 2 groups were selected from a prospective cohort of patients undergoing surgical procedures at 2 tertiary care university hospitals, who were at high risk for postoperative infectious complications. Included individuals were aged 40 years or older; had no history of autoimmune disease, immunocompromised state, immune-modulating medication, or active infection; and were scheduled to undergo elective cardiac, vascular, spinal, or intracranial surgical procedure.

--Among 197 participants, 553 bacterial taxa were identified from preoperative nasal swab samples. A 2-cluster model accounted for the largest proportion of variance in microbial profiles using grades of membership modeling and was most parsimonious.

--After adjusting for potential confounders, the probability of assignment to cluster 2 was associated with 6-fold higher odds of infection after surgical procedure independent of baseline clinical characteristics, including nasal carriage of Staphylococcus aureus.

--Intrasample diversity was inversely associated with infectious outcome in both clusters; however, the probability of assignment to cluster 2 was associated with higher odds of infection independent of intrasample diversity.

Conclusively, the nasal microbiome was an independent risk factor associated with infectious outcomes among individuals who underwent elective surgical procedures and may serve as a biomarker associated with infection susceptibility in this population.

Source: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2779303
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