Contribution of the patient microbiome to surgical site infection and antibiotic prophylaxis failure in spine surgery

Surgical site infection (SSI) remains a significant complication of surgery, with high rates of antimicrobial resistance. A study using instrumented spine surgery found that 86% of SSIs originated from preoperative strains, with no common source infection among a superset of 1610 patients. Most SSI isolates (59%) were resistant to the prophylactic antibiotic administered during surgery, correlated with the patient’s preoperative resistome. This suggests the need for SSI prevention strategies tailored to the preoperative microbiome and resistome present in individual patients.