Correlation between a real-time bioparticle detection device and a traditional microbiological active air sampler monitoring air quality in an operating room during elective arthroplasty surgery: a prospective feasibility study
Journal article, 2025

Background and purpose: The standard method for controlling operating room (OR) air quality is measuring bacteria-carrying particles per volume unit of air: colony forming units (CFU/m3). The result takes at least 2 days after sampling. Another method is real-time measurements of fluorescing bioparticles per unit volume of air (FBP/dm3). We aimed to compare simultaneous measurements of FBP/50 dm3 and CFU/m3 during ongoing arthroplasty surgery. Methods: 18 arthroplasties were performed in a modern OR with turbulent mixed airflow ventilation. The sampling heads of a BioAerosol Monitoring System (BAMS) and a microbiological active air sampler (Sartorius MD8 Air Sampler) were placed next to each other, and 6 parallel 10-minute registrations of FBP/50 dm3 and CFU/m3 were performed for each surgery. Parallel measurements were plotted against each other, Passing–Bablok nonparametric linear regression was performed, and the Spearman correlation coefficient (r) was calculated. Results: The r between FBP ≥ 3 μm/50 dm3 and CFU/m3 sampled for 96 x 10-minute intervals, was 0.70 (95% confidence interval [CI] 0.57–0.79). In the 25th percentile with the lowest 10-minute FBP ≥ 3μm/50 dm3, there were no CFU measurements with ≥ 10 and 4% with ≥ 5 CFU/m3. In the 75th percentile with the highest 10-minute FBP ≥ 3 μm/50 dm3, there were 58% CFU measurements with ≥ 10 and 88% with ≥ 5 CFU/m3. The r between FBP ≥ 3 μm/50 dm3 and CFU/m3 means sampled during 18 operations was 0.87 (CI 0.68–0.95). Conclusion: Low FBP ≥ 3 μm/50 dm3 measured by BAMS indicates low CFU/m3; conversely, high FBP ≥ 3 μm/50 dm3 indicates high CFU/m3. Real-time measurements of FBP ≥ 3 μm/50 dm3 can be used as a supplement to CFU/m3 monitoring OR air bacterial load.

Hip

Implants

Knee

Infection

Arthroplasty

Author

Lise Lott Larsson

Karolinska Institutet

Johan Nordenadler

Karolinska Institutet

Gunilla Björling

Karolinska Institutet

Jönköping University

Li Felländer-Tsai

Karolinska Institutet

Karolinska University Hospital

Stergios Lazarinis

Uppsala University

Bengt Ljungqvist

Chalmers, Architecture and Civil Engineering, Building Services Engineering

Janet Mattsson

Karolinska Institutet

University of South-Eastern Norway (USN)

Berit Reinmüller

Chalmers, Architecture and Civil Engineering, Building Services Engineering

Harald Brismar

Karolinska University Hospital

Karolinska Institutet

Acta Orthopaedica

1745-3674 (ISSN) 1745-3682 (eISSN)

Vol. 96 176-181

Subject Categories (SSIF 2025)

Orthopaedics

DOI

10.2340/17453674.2025.43002

PubMed

39993175

Related datasets

URI: https://actaorthop.org/actao/article/view/43002/49260

More information

Latest update

3/21/2025