Abstract
Background: Healthcare-associated infections (HAIs) persist as a critical challenge in anesthesia practice due to high-risk procedures, complex equipment, and time-sensitive care. Despite advances in sterile techniques, the anesthesia workspace remains a reservoir for multidrug-resistant organisms (MDROs), with lapses in compliance and gaps in infection control protocols exacerbating risks. This systematic review evaluated the efficacy of current infection prevention strategies in the anesthesia work environment, identified gaps in practice, and proposed evidence-based solutions to reduce HAIs.
Methods: A systematic review of peer-reviewed articles (1990–2024) was conducted using PubMed, Scopus, Web of Science, ScienceDirect, and Google Scholar databases, yielding 826 initial references. After screening, 17 high-quality studies met the inclusion criteria (systematic reviews, randomized trials, and WHO/CDC guidelines). Two independent reviewers screened articles, resolved discrepancies via consensus, and excluded non-peer-reviewed or industry-funded studies. Hand hygiene, environmental disinfection, medication safety, provider education, laryngoscope management, and airway safety were key domains analyzed in this study.
Results: Hand hygiene compliance among anesthesia providers was suboptimal (40%–60%), lagging behind surgical teams. Environmental disinfection was inconsistent, and less than 35% of high-touch surfaces (e.g., anesthesia machines and intravenous poles) were cleaned between cases. Microbial contamination occurred in 12% of multi-dose vials, and closed-system transfer devices reduced contamination risks by 40%–60%. Laryngoscope handles harbored pathogens in 30% of cases post-procedure. Simulation-based education improved compliance 27-fold. Eventually, ultraviolet-C (UV-C) decontamination and “bundled” strategies reduced workspace contamination by 27%.
Conclusion: To mitigate HAIs in anesthesia, it is essential to have a multimodal approach that combines standardized protocols, single-use equipment, technological innovations (e.g., UV-C systems), and cultural shifts toward collective accountability. Prioritizing resource allocation, enhancing provider education, and integrating real-time compliance feedback can bridge guideline-practice gaps, transforming the anesthesia environment into a model of sterility and patient safety.