Microbial contamination and pathogen transmission in the anaesthesia work area: a bibliometric analysis and evidence-gap assessment, 1990-2025

AbstractObjective: The anaesthesia work area is an established reservoir for microbial contamination and a route of perioperative pathogen transmission, but the literature around it has not been mapped. This study described that literature's size, growth, geography, collaboration structure, intellectual base and conceptual structure, and its evidence gaps. Methods: Scopus records combining anaesthesia and perioperative-setting terms with contamination and transmission terms (articles and reviews; English; 1990-2025) were retrieved on 24 July 2026 and screened in two stages. Relevance screening used two independent large language model assessors working from a common rubric; records were retained only when both judged them relevant (inter-assessor Cohen κ=0.887). The corpus was cross-checked against OpenAlex. Performance analysis, collaboration and co-citation networks, co-word analysis and trend-topic detection were produced with bibliometrix 5.4.1 (R 4.5.0) and VOSviewer. Results: The corpus comprised 302 documents (268 articles, 34 reviews) published in 120 sources by 1,281 authors from 37 countries and attracting 8,049 citations (mean 26.7, median 13.5). Output grew steadily, 61% appearing from 2010 onward, with a pulse in 2020 linked to COVID-19. Anesthesia and Analgesia and the American Journal of Infection Control led the sources. One author (R.W. Loftus; 41 documents, 1,513 citations) and one country (United States, 149 documents) dominated, and international co-authorship reached only 6.6%. The intellectual base rested on a single programme of intraoperative transmission research together with the 1995 propofol outbreak report. Conclusion: The field is coherent but narrowly based. Independent multicentre replication, trials with postoperative-infection endpoints and extension to under-studied settings are its clearest priorities.