OR PathTrac (Tracking Intra-operative Bacterial Transmission)

Two patients undergoing sedation in a randomly selected operating room will be evaluated in a serial manner in order to detect transmission of pathogenic bacteria. Patient care will not change due to their participation in this study; the patients will undergo sedation and surgery according to usual practice. This study involves taking microbiology cultures from various places in the operating room before and after each procedure. Cultures will also be taken from the two patients after they are asleep and from their intravenous tubing. From both patients anesthesiologist, surgeon and their surgical team, cRNA, and nursing staff will also have cultures obtained. Each cultures will be de-identified and given a study ID number before transport to the research laboratory for microbiological assay. The patient's medical record will be reviewed for 30 days after surgery to surveil for documentation of a potential hospital acquired infection.

Primary outcomes

• Identify transmission dynamics of pathogenic bacteria (i.e. Staph aureus). [Intraoperative period]: Focus on how Staph aureus is transmitted in the operating room by identifying key areas of origin.
• Intraoperative clonal transmission of Staph aureus. [Intraoperative period]: Monitor locations throughout the operating room to document clonal transmission from the area of origin.
• Identify the modes of transmission of pathogenic bacteria ((i.e. Staph aureus). [Intraoperative period]: If transmission of Staph aureus from the site of origin to another site in the operating room arena is documented, identify the modes of transmission.

Secondary outcomes

• Monitor for post operative healthcare associated infections. [Up to 30 days following surgery]: Monitor for the presence or absence of healthcare associated infection after undergoing an operative procedure.
• Surveil for molecular links between pathogenic organisms. [Up to 30 days following surgery]: Seek to identify molecular links between causative organisms of infection and bacteria found in the operating room at the time of surgery.

Sex: All, ages: 18 Years to 105 Years, accepts healthy volunteers

Inclusion Criteria:

* At least 18 years of age
* Require peripheral intravenous and/or central venous catheter placement
* Undergoing gynecology/oncology, colorectal, open vascular, total joint or cardiovascular procedures.

Exclusion Criteria:

* Less than 18 years of age
* Does not require peripheral intravenous and/or central venous catheter placement
* Patient refusal to participate
* Incarceration

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• Sundara Reddy, MBBS, FRCA, Principal investigator, University of Iowa