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Infections after surgery are more likely due to bacteria already on your skin than from microbes in the hospital − new research

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theconversation.com – Dustin Long, Assistant Professor of Anesthesiology, School of Medicine, University of Washington – 2024-04-10 13:01:31

Genetic analysis of the bacteria causing surgical site infections revealed that many were already present on the patient’s skin.
Ruben Bonilla Gonzalo/Moment via Getty Images

Dustin Long, University of Washington and Chloe Bryson-Cahn, University of Washington

Health care providers and patients have traditionally thought that infections patients get while in the hospital are caused by superbugs they’re exposed to while they’re in a medical facility. Genetic data from the bacteria causing these infections – think CSI for E. coli – tells another story: Most health care-associated infections are caused by previously harmless bacteria that patients already had on their bodies before they even entered the hospital.

Research comparing bacteria in the microbiome – those colonizing our noses, skin and other areas of the body – with the bacteria that cause pneumonia, diarrhea, bloodstream infections and surgical site infections shows that the bacteria living innocuously on our own bodies when we’re healthy are most often responsible for these bad infections when we’re sick.

Our newly published research in Science Translational Medicine adds to the growing number of studies supporting this idea. We show that many surgical site infections after spinal surgery are caused by microbes that are already on the patient’s skin.

Surgical infections are a persistent problem

Among the different types of heath care-associated infections, surgical site infections stand out as particularly problematic. A 2013 study found that surgical site infections contribute the most to the annual costs of hospital-acquired infections, totaling over 33% of the US$9.8 billion spent annually. Surgical site infections are also a significant cause of hospital readmission and death after surgery.

In our work as clinicians at Harborview Medical Center at the University of Washington – yes, the one in Seattle that “Grey’s Anatomy” was supposedly based on – we’ve seen how hospitals go to extraordinary lengths to prevent these infections. These include sterilizing all surgical equipment, using ultraviolet light to clean the operating room, following strict protocols for surgical attire and monitoring airflow within the operating room.

Surgeon helping another surgeon put on gloves
Hospitals follow strict protocols to prevent infections resulting from surgical procedures.
Morsa Images/DigitalVision via Getty Images

Still, surgical site infections occur following about 1 in 30 procedures, typically with no explanation. While rates of many other medical complications have shown steady improvement over time, data from the Agency for Healthcare Research and Quality and the Centers for Disease Control and Prevention show that the problem of surgical site infection is not getting better.

In fact, because administering antibiotics during surgery is a cornerstone of infection prevention, the global rise of antibiotic resistance is forecast to increase infection rates following surgery.

BYOB (Bring your own bacteria)

As a team of physician-scientists with expertise including critical care, infectious diseases, laboratory medicine, microbiology, pharmacy, orthopedics and neurosurgery, we wanted to better understand how and why surgical infections were occurring in our patients despite following recommended protocols to prevent them.

Prior studies on surgical site infection have been limited to a single species of bacteria and used older genetic analysis methods. But new technologies have opened the door to studying all types of bacteria and testing their antibiotic resistance genes simultaneously.

We focused on infections in spinal surgery for a few reasons. First, similar numbers of women and men undergo spine surgery for various reasons across their life spans, meaning our results would be applicable to a larger group of people. Second, more health care resources are expended on spinal surgery than any other type of surgical procedure in the U.S. Third, infection following spine surgery can be particularly devastating for patients because it often requires repeat surgeries and long courses of antibiotics for a chance at a cure.

Over a one-year period, we sampled the bacteria living in the nose, skin and stool of over 200 patients before surgery. We then followed this group for 90 days to compare those samples with any infections that later occurred.

Microscopy image of clusters of spherical bacteria stained yellow against a green background
Staphylococcus aureus is a common cause of hospital-acquired bacterial infections.
CDC/Janice Haney Carr/Jeff Hageman, M.H.S.

Our results revealed that while the species of bacteria living on the back skin of patients vary remarkably between people, there are some clear patterns. Bacteria colonizing the upper back around the neck and shoulders are more similar to those in the nose; those normally present on the lower back are more similar to those in the gut and stool. The relative frequency of their presence in these skin regions closely mirrors how often they show up in infections after surgery on those same specific regions of the spine.

In fact, 86% of the bacteria causing infections after spine surgery were genetically matched to bacteria a patient carried before surgery. That number is remarkably close to estimates from earlier studies using older genetic techniques focused on Staphylococcus aureus.

Nearly 60% of infections were also resistant to the preventive antibiotic administered during surgery, the antiseptic used to clean the skin before incision or both. It turns out the source of this antibiotic resistance was also not acquired in the hospital but from microbes the patient had already been living with unknowingly. They likely acquired these antibiotic-resistant microbes through prior antibiotic exposure, consumer products or routine community contact.

Preventing surgical infections

At face value, our results may seem intuitive – surgical wound infections come from bacteria that hang out around that part of the body. But this realization has some potentially powerful implications for prevention and care.

If the most likely source of surgical infection – the patient’s microbiome – is known in advance, this presents medical teams with an opportunity to protect against it prior to a scheduled procedure. Current protocols for infection prevention, such as antibiotics or topical antiseptics, follow a one-size-fits-all model – for example, the antibiotic cefazolin is used for any patient undergoing most procedures – but personalization could make them more effective.

If you were having a major surgery today, no one would know whether the site where your incision will be made was colonized with bacteria resistant to the standard antibiotic regimen for that procedure. In the future, clinicians could use information about your microbiome to select more targeted antimicrobials. But more research is needed on how to interpret that information and understand whether such an approach would ultimately lead to better outcomes.

Today, practice guidelines, commercial product development, hospital protocols and accreditation related to infection prevention are often focused on sterility of the physical environment. The fact that most infections don’t actually start with sources in the hospital is probably a testament to the efficacy of these protocols. But we believe that shifting toward more patient-centered, individualized approaches to infection prevention has the potential to benefit hospitals and patients alike.The Conversation

Dustin Long, Assistant Professor of Anesthesiology, School of Medicine, University of Washington and Chloe Bryson-Cahn, Associate Professor of Allergy and Infectious Diseases, School of Medicine, University of Washington

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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Contaminated milk from one plant in Illinois sickened thousands with Salmonella in 1985 − as outbreaks rise in the US, lessons from this one remain true

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theconversation.com – Michael Petros, Clinical Assistant Professor of Environmental and Occupational Health Sciences, University of Illinois Chicago – 2025-05-07 07:34:00

A valve that mixed raw milk with pasteurized milk at Hillfarm Dairy may have been the source of contamination. This was the milk processing area of the plant.
AP Photo/Mark Elias

Michael Petros, University of Illinois Chicago

In 1985, contaminated milk in Illinois led to a Salmonella outbreak that infected hundreds of thousands of people across the United States and caused at least 12 deaths. At the time, it was the largest single outbreak of foodborne illness in the U.S. and remains the worst outbreak of Salmonella food poisoning in American history.

Many questions circulated during the outbreak. How could this contamination occur in a modern dairy farm? Was it caused by a flaw in engineering or processing, or was this the result of deliberate sabotage? What roles, if any, did politics and failed leadership play?

From my 50 years of working in public health, I’ve found that reflecting on the past can help researchers and officials prepare for future challenges. Revisiting this investigation and its outcome provides lessons on how food safety inspections go hand in hand with consumer protection and public health, especially as hospitalizations and deaths from foodborne illnesses rise.

Contamination, investigation and intrigue

The Illinois Department of Public Health and the U.S. Centers for Disease Control and Prevention led the investigation into the outbreak. The public health laboratories of the city of Chicago and state of Illinois were also closely involved in testing milk samples.

Investigators and epidemiologists from local, state and federal public health agencies found that specific lots of milk with expiration dates up to April 17, 1985, were contaminated with Salmonella. The outbreak may have been caused by a valve at a processing plant that allowed pasteurized milk to mix with raw milk, which can carry several harmful microorganisms, including Salmonella.

Overall, labs and hospitals in Illinois and five other Midwest states – Indiana, Iowa, Michigan, Minnesota and Wisconsin – reported over 16,100 cases of suspected Salmonella poisoning to health officials.

To make dairy products, skimmed milk is usually separated from cream, then blended back together in different levels to achieve the desired fat content. While most dairies pasteurize their products after blending, Hillfarm Dairy in Melrose Park, Illinois, pasteurized the milk first before blending it into various products such as skim milk and 2% milk.

Subsequent examination of the production process suggested that Salmonella may have grown in the threads of a screw-on cap used to seal an end of a mixing pipe. Investigators also found this strain of Salmonella 10 months earlier in a much smaller outbreak in the Chicago area.

Microscopy image of six rod-shaped bacteria against a black background
Salmonella is a common cause of food poisoning.
Volker Brinkmann/Max Planck Institute for Infection Biology via PLoS One, CC BY-SA

Finding the source

The contaminated milk was produced at Hillfarm Dairy in Melrose Park, which was operated at the time by Jewel Companies Inc. During an April 3 inspection of the company’s plant, the Food and Drug Administration found 13 health and safety violations.

The legal fallout of the outbreak expanded when the Illinois attorney general filed suit against Jewel Companies Inc., alleging that employees at as many as 18 stores in the grocery chain violated water pollution laws when they dumped potentially contaminated milk into storm sewers. Later, a Cook County judge found Jewel Companies Inc. in violation of the court order to preserve milk products suspected of contamination and maintain a record of what happened to milk returned to the Hillfarm Dairy.

Political fallout also ensued. The Illinois governor at the time, James Thompson, fired the director of the Illinois Public Health Department when it was discovered that he was vacationing in Mexico at the onset of the outbreak and failed to return to Illinois. Notably, the health director at the time of the outbreak was not a health professional. Following this episode, the governor appointed public health professional and medical doctor Bernard Turnock as director of the Illinois Department of Public Health.

In 1987, after a nine-month trial, a jury determined that Jewel officials did not act recklessly when Salmonella-tainted milk caused one of the largest food poisoning outbreaks in U.S. history. No punitive damages were awarded to victims, and the Illinois Appellate Court later upheld the jury’s decision.

YouTube video
Raw milk is linked to many foodborne illnesses.

Lessons learned

History teaches more than facts, figures and incidents. It provides an opportunity to reflect on how to learn from past mistakes in order to adapt to future challenges. The largest Salmonella outbreak in the U.S. to date provides several lessons.

For one, disease surveillance is indispensable to preventing outbreaks, both then and now. People remain vulnerable to ubiquitous microorganisms such as Salmonella and E. coli, and early detection of an outbreak could stop it from spreading and getting worse.

Additionally, food production facilities can maintain a safe food supply with careful design and monitoring. Revisiting consumer protections can help regulators keep pace with new threats from new or unfamiliar pathogens.

Finally, there is no substitute for professional public health leadership with the competence and expertise to respond effectively to an emergency.The Conversation

Michael Petros, Clinical Assistant Professor of Environmental and Occupational Health Sciences, University of Illinois Chicago

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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The post Contaminated milk from one plant in Illinois sickened thousands with Salmonella in 1985 − as outbreaks rise in the US, lessons from this one remain true appeared first on theconversation.com



Note: The following A.I. based commentary is not part of the original article, reproduced above, but is offered in the hopes that it will promote greater media literacy and critical thinking, by making any potential bias more visible to the reader –Staff Editor.

Political Bias Rating: Centrist

The article provides an analytical, factual recounting of the 1985 Salmonella outbreak, with an emphasis on public health, safety standards, and lessons learned from past mistakes. It critiques the failures in leadership and oversight during the incident but avoids overt ideological framing. While it highlights political accountability, particularly the firing of a public health official and the appointment of a medical professional, it does so in a balanced manner without assigning blame to a specific political ideology. The content stays focused on the public health aspect and the importance of professional leadership, reflecting a centrist perspective in its delivery.

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Predictive policing AI is on the rise − making it accountable to the public could curb its harmful effects

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theconversation.com – Maria Lungu, Postdoctoral Researcher of Law and Public Administration, University of Virginia – 2025-05-06 07:35:00

Data like this seven-day crime map from Oakland, Calif., feeds predictive policing AIs.
City of Oakland via CrimeMapping.com

Maria Lungu, University of Virginia

The 2002 sci-fi thriller “Minority Report” depicted a dystopian future where a specialized police unit was tasked with arresting people for crimes they had not yet committed. Directed by Steven Spielberg and based on a short story by Philip K. Dick, the drama revolved around “PreCrime” − a system informed by a trio of psychics, or “precogs,” who anticipated future homicides, allowing police officers to intervene and prevent would-be assailants from claiming their targets’ lives.

The film probes at hefty ethical questions: How can someone be guilty of a crime they haven’t yet committed? And what happens when the system gets it wrong?

While there is no such thing as an all-seeing “precog,” key components of the future that “Minority Report” envisioned have become reality even faster than its creators imagined. For more than a decade, police departments across the globe have been using data-driven systems geared toward predicting when and where crimes might occur and who might commit them.

Far from an abstract or futuristic conceit, predictive policing is a reality. And market analysts are predicting a boom for the technology.

Given the challenges in using predictive machine learning effectively and fairly, predictive policing raises significant ethical concerns. Absent technological fixes on the horizon, there is an approach to addressing these concerns: Treat government use of the technology as a matter of democratic accountability.

Troubling history

Predictive policing relies on artificial intelligence and data analytics to anticipate potential criminal activity before it happens. It can involve analyzing large datasets drawn from crime reports, arrest records and social or geographic information to identify patterns and forecast where crimes might occur or who may be involved.

Law enforcement agencies have used data analytics to track broad trends for many decades. Today’s powerful AI technologies, however, take in vast amounts of surveillance and crime report data to provide much finer-grained analysis.

Police departments use these techniques to help determine where they should concentrate their resources. Place-based prediction focuses on identifying high-risk locations, also known as hot spots, where crimes are statistically more likely to happen. Person-based prediction, by contrast, attempts to flag individuals who are considered at high risk of committing or becoming victims of crime.

These types of systems have been the subject of significant public concern. Under a so-called “intelligence-led policing” program in Pasco County, Florida, the sheriff’s department compiled a list of people considered likely to commit crimes and then repeatedly sent deputies to their homes. More than 1,000 Pasco residents, including minors, were subject to random visits from police officers and were cited for things such as missing mailbox numbers and overgrown grass.

YouTube video
Lawsuits forced the Pasco County, Fla., Sheriff’s Office to end its troubled predictive policing program.

Four residents sued the county in 2021, and last year they reached a settlement in which the sheriff’s office admitted that it had violated residents’ constitutional rights to privacy and equal treatment under the law. The program has since been discontinued.

This is not just a Florida problem. In 2020, Chicago decommissioned its “Strategic Subject List,” a system where police used analytics to predict which prior offenders were likely to commit new crimes or become victims of future shootings. In 2021, the Los Angeles Police Department discontinued its use of PredPol, a software program designed to forecast crime hot spots but was criticized for low accuracy rates and reinforcing racial and socioeconomic biases.

Necessary innovations or dangerous overreach?

The failure of these high-profile programs highlights a critical tension: Even though law enforcement agencies often advocate for AI-driven tools for public safety, civil rights groups and scholars have raised concerns over privacy violations, accountability issues and the lack of transparency. And despite these high-profile retreats from predictive policing, many smaller police departments are using the technology.

Most American police departments lack clear policies on algorithmic decision-making and provide little to no disclosure about how the predictive models they use are developed, trained or monitored for accuracy or bias. A Brookings Institution analysis found that in many cities, local governments had no public documentation on how predictive policing software functioned, what data was used, or how outcomes were evaluated.

YouTube video
Predictive policing can perpetuate racial bias.

This opacity is what’s known in the industry as a “black box.” It prevents independent oversight and raises serious questions about the structures surrounding AI-driven decision-making. If a citizen is flagged as high-risk by an algorithm, what recourse do they have? Who oversees the fairness of these systems? What independent oversight mechanisms are available?

These questions are driving contentious debates in communities about whether predictive policing as a method should be reformed, more tightly regulated or abandoned altogether. Some people view these tools as necessary innovations, while others see them as dangerous overreach.

A better way in San Jose

But there is evidence that data-driven tools grounded in democratic values of due process, transparency and accountability may offer a stronger alternative to today’s predictive policing systems. What if the public could understand how these algorithms function, what data they rely on, and what safeguards exist to prevent discriminatory outcomes and misuse of the technology?

The city of San Jose, California, has embarked on a process that is intended to increase transparency and accountability around its use of AI systems. San Jose maintains a set of AI principles requiring that any AI tools used by city government be effective, transparent to the public and equitable in their effects on people’s lives. City departments also are required to assess the risks of AI systems before integrating them into their operations.

If taken correctly, these measures can effectively open the black box, dramatically reducing the degree to which AI companies can hide their code or their data behind things such as protections for trade secrets. Enabling public scrutiny of training data can reveal problems such as racial or economic bias, which can be mitigated but are extremely difficult if not impossible to eradicate.

Research has shown that when citizens feel that government institutions act fairly and transparently, they are more likely to engage in civic life and support public policies. Law enforcement agencies are likely to have stronger outcomes if they treat technology as a tool – rather than a substitute – for justice.The Conversation

Maria Lungu, Postdoctoral Researcher of Law and Public Administration, University of Virginia

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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The post Predictive policing AI is on the rise − making it accountable to the public could curb its harmful effects appeared first on theconversation.com



Note: The following A.I. based commentary is not part of the original article, reproduced above, but is offered in the hopes that it will promote greater media literacy and critical thinking, by making any potential bias more visible to the reader –Staff Editor.

Political Bias Rating: Center-Left

The article provides an analysis of predictive policing, highlighting both the technological potential and ethical concerns surrounding its use. While it presents factual information, it leans towards caution and skepticism regarding the fairness, transparency, and potential racial biases of these systems. The framing of these issues, along with an emphasis on democratic accountability, transparency, and civil rights, aligns more closely with center-left perspectives that emphasize government oversight, civil liberties, and fairness. The critique of predictive policing technologies without overtly advocating for their abandonment reflects a balanced but cautious stance on technology’s role in law enforcement.

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Worsening allergies aren’t your imagination − windy days create the perfect pollen storm

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theconversation.com – Christine Cairns Fortuin, Assistant Professor of Forestry, Mississippi State University – 2025-05-05 07:45:00

Windy days can mean more pollen and more sneezing.
mladenbalinovac/E+ via Getty Images

Christine Cairns Fortuin, Mississippi State University

Evolution has fostered many reproductive strategies across the spectrum of life. From dandelions to giraffes, nature finds a way.

One of those ways creates quite a bit of suffering for humans: pollen, the infamous male gametophyte of the plant kingdom.

In the Southeastern U.S., where I live, you know it’s spring when your car has turned yellow and pollen blankets your patio furniture and anything else left outside. Suddenly there are long lines at every car wash in town.

A car covered in yellow. Someone drew a smiley face with the words 'LOLLEN,' with LOL underlined.
On heavy pollen days, cars can end up covered in yellow grains.
Scott Akerman/Flickr, CC BY

Even people who aren’t allergic to pollen – clearly an advantage for a pollination ecologist like me – can experience sneezing and watery eyes during the release of tree pollen each spring. Enough particulate matter in the air will irritate just about anyone, even if your immune system does not launch an all-out attack.

So, why is there so much pollen? And why does it seem to be getting worse?

2 ways trees spread their pollen

Trees don’t have an easy time in the reproductive game. As a tree, you have two options to disperse your pollen.

Option 1: Employ an agent, such as a butterfly or bee, that can carry your pollen to another plant of the same species.

The downside of this option is that you must invest in a showy flower display and a sweet scent to advertise yourself, and sugary nectar to pay your agent for its services.

A bee noses into a white flower.
A bee enjoys pollen from a cherry blossom. Pollen is a primary source of protein for bees.
Ivan Radic/Flickr, CC BY

Option 2, the budget option, is much less precise: Get a free ride on the wind.

Wind was the original pollinator, evolving long before animal-mediated pollination. Wind doesn’t require a showy flower nor a nectar reward. What it does require for pollination to succeed is ample amounts of lightweight, small-diameter pollen.

Why wind-blown pollen makes allergies worse

Wind is not an efficient pollinator, however. The probability of one pollen grain landing in the right location – the stigma or ovule of another plant of the same species – is infinitesimally small.

Therefore, wind-pollinated trees must compensate for this inefficiency by producing copious amounts of pollen, and it must be light enough to be carried.

For allergy sufferers, that can mean air filled with microscopic pollen grains that can get into your eyes, throat and lungs, sneak in through window screens and convince your immune system that you’ve inhaled a dangerous intruder.

Tiny flowers on a live oak tree.
When wind blows the tiny pollen grains of live oaks, allergy sufferers feel it.
Charles Willgren/Flickr, CC BY

Plants relying on animal-mediated pollination, by contrast, can produce heavier and stickier pollen to adhere to the body of an insect. So don’t blame the bees for your allergies – it’s really the wind.

Climate change has a role here, too

Plants initiate pollen release based on a few factors, including temperature and light cues. Many of our temperate tree species respond to cues that signal the beginning of spring, including warmer temperatures.

Studies have found that pollen seasons have intensified in the past three decades as the climate has warmed. One study that examined 60 location across North America found pollen seasons expanded by an average of 20 days from 1990 to 2018 and pollen concentrations increased by 21%.

That’s not all. Increasing carbon dioxide levels may also be driving increases in the quantity of tree pollen produced.

Why the Southeast gets socked

What could make this pollen boost even worse?

For the Southeastern U.S. in particular, strong windstorms are becoming more common and more intense − and not just hurricanes.

Anyone who has lived in the Southeast for the past couple of decades has likely noticed this. The region has more tornado warnings, more severe thunderstorms, more power outages. This is especially true in the mid-South, from Mississippi to Alabama.

A map showing windiest events in the Southeast are over Alabama and Mississippi.
Severity of wind and storm events mapped from NOAA data, 2012-2019, shows high activity over Mississippi and Alabama. Red areas have the most severe events.
Christine Cairns Fortuin

Since wind is the vector of airborne pollen, windier conditions can also make allergies worse. Pollen remains airborne for longer on windy days, and it travels farther.

To make matters worse, increasing storm activity may be doing more than just transporting pollen. Storms can also break apart pollen grains, creating smaller particles that can penetrate deeper into the lungs.

Many allergy sufferers may notice worsening allergies during storms.

The peak of spring wind and storm season tends to correspond to the timing of the release of tree pollen that blankets our world in yellow. The effects of climate change, including longer pollen seasons and more pollen released, and corresponding shifts in windy days and storm severity are helping to create the perfect pollen storm.The Conversation

Christine Cairns Fortuin, Assistant Professor of Forestry, Mississippi State University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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The post Worsening allergies aren’t your imagination − windy days create the perfect pollen storm appeared first on theconversation.com



Note: The following A.I. based commentary is not part of the original article, reproduced above, but is offered in the hopes that it will promote greater media literacy and critical thinking, by making any potential bias more visible to the reader –Staff Editor.

Political Bias Rating: Centrist

The content is a scientific and educational article focusing on the biology of pollen, its effects on allergies, and the influence of climate change on pollen production. It presents factual information supported by research studies and references, without taking a partisan stance. While it acknowledges climate change as a factor, the discussion remains grounded in scientific observation rather than political opinion, leading to a neutral, centrist tone.

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