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

Surgical site infection (SSI), historically was considered the greatest contributor to in-hospital mortality during the pre-antibiotic and pre-antiseptic surgery era.European SSI surveillance data today demonstrate a marked improvement in the rate of SSIs, with current rates ranging from 0.6%-1.2%for clean orthopaedic procedures to 1.5%-9.5% or more for clean-contaminated abdominal surgery. 1 Especially for clean procedures, preventative measures focus on antiseptic approaches directed at keeping exogenous infectious agents out of the surgical field.The elegant study by Long et al. forces surgeons, microbiologist, infection prevention experts and infectious diseases physicians to consider endogenous sources of infection for SSI pathogens and to consider prevention measures beyond those limited to the external environment alone. 2