Fighting Antimicrobial Resistance With a New Weapon

Surgical site infections (SSI) are a constant fight for infection preventionists (IPs), surgeons, and nurses. Infection Control Today® (ICT®) covers the topics frequently because, to overcome the issue, those medical personnel involved must have a multi-pronged attack. Prevention innovations are proposed continually in the fight against the antimicrobial resistance (AMR) that cause 2.8 million infections annually.

Anthony Senagore, MD, a leading colorectal surgeon and senior medical director of PolyPid recently spoke ICT® about ways to address AMR by changing how surgeons and other health care workers administer antibiotics. In the exclusive interview, he discussed the battle against AMR and SSIs, and the innovative technology that his company has created and how it will help prevent AMR in many different situations. Senagore describes PLEX (Polymer-Lipid Encapsulation matriX) platform as a matrix made of alternating layers of polymers and lipids that entrap a therapeutic drug.

In previous positions, Senagore has served as Professor of Surgery at several prestigious academic medical centers, including University of Texas Medical Branch at Galveston, Central Michigan University College of Medicine, the University of Southern California, Keck School of Medicine, Cleveland Clinic Foundation, and Spectrum Health/Michigan State University.

“We focus on local delivery of drugs in the wound bed for extended periods of time. So that delivery addresses the current gap in surgical site infection,” Senagore told ICT®. “During a surgical procedure, no matter what you do, the wound is slowly contaminated during the conduct of the procedure. And that continues up to the time that the skin is closed. Almost everything that we do now for prophylaxis peaks prior to that point and diminishes over time rapidly. [Our company] focuses on a solution applied right at the point of the theoretical maximum contamination and continue to add for 30-day delivery.”

Other measures to prevent AMR and SSIs:

• Antimicrobials.
• Disinfectants.
• Disposables and Single Patient Use.
• Equipment Covers.
• Face Mask Dispensers.
• Glove Box Dispensers.
• Hand Hygiene.
• Isolation Stations.
• Clean skin, including using alcohol-based CHG skin wipes
• Sterile clothing and Surgical Drape
• Clean air/ventilation
• UV lights
• Discussions, checking in with post-operative patients about infection prevention care.
• Chlorhexidine (CHG) showers
• Preventive antibiotics
• Hair removal
• Skin preparation in the surgery
• Sterile dressings
• Touchless electrostatic sprayer technologies
• Clean water
• Pre-surgery discussions and pamphlets with patients on surgical site infections

In a recent ICT® article, Franklin Dexter, MD, PhD, FASA, discussed how SSIs are prevalent in the OR. “Substantial understanding exists about how OR pathogens cause surgical-site infections,” Dexter wrote, “It is known that the processes involved include not only contaminated wounds and resistance to otherwise appropriate antibiotics, but also bacterial transmission including the anesthesia environment.2Feedback to anesthesia practitioners contributes to reduced surgical-site infections because that transmission can be mitigated with basic measures.”

Audrey Friedman, RN, CLNC, discussed the role IPs play in thwarting surgical site infections.“Addressing strategies for the prevention of SSI can include all avenues of patient care and involve all actual and potential participants in the care continuum, from patients and families in the pre- and posthospital settings to hospital and facility administrators to physicians and nurses to laboratory and supply chains to quality and risk management departments.”

In his interview with ICT®, Senagore continues the discussion on these measures Dexter and Friedman mention.