# Targeting the Patient Microbiome for the Prevention of Surgical Site Infection in Spine Surgery

> **NIH NIH K23** · UNIVERSITY OF WASHINGTON · 2022 · $166,320

## Abstract

PROJECT SUMMARY/ABSTRACT
 Surgical site infection (SSI) is a major public health problem with devastating perioperative outcomes,
affecting as many as 1 in 20 patients undergoing instrumented spine surgery. Procedures such as spinal fusion
comprise the largest overall category of US spending on surgical care and are frequently performed for
patients with pain or disability arising from a wide range of musculoskeletal conditions, such as congenital or
degenerative disease, trauma, and neoplastic disorders. However, SSI rates in instrumented spine surgery are
among the highest of any procedure involving a clean skin incision and they have not substantially decreased
in decades. The development of more effective strategies for SSI prevention in spine surgery is significantly
limited by a lack of fundamental understanding about the origins of causative bacteria, the basic pathogenesis
of spinal wound infection, the microbiome of the back, and the role of antimicrobial resistance to surgical
prophylaxis. We recently demonstrated that the microbiologic causes of spine SSI may vary by operative level
and patient sex, and that most infections are resistant to the surgical antibiotic prophylaxis administered.
 The objectives of this K23 proposal are to build upon this foundation through training in translational
microbiome sciences and by prospectively characterizing the role of the patient microbiome in spine SSI. The
central hypothesis is that most spine SSIs arise from strains colonizing the patient prior to surgery (rather
than acquired in the hospital environment) and that clinically actionable features of the preoperative patient
microbiome strongly influence individual, modifiable risk. The long-term objective of this work is to use novel
bacterial genomic techniques and large clinical datasets to identify the fundamental mechanisms by which
spinal wound infection occurs, enabling the development of more effective prevention strategies. The specific
aims of this proposal are to: 1) define preoperative bacterial genetic features of Staphylococcus aureus
associated with spine SSI, allowing development of improved screening and decolonization measures, 2)
identify sources of endogenous gram-negative spine SSI and associated resistance to surgical antibiotic
prophylaxis, enabling prevention strategies for this important class of infection that may disproportionately
affect specific groups (e.g., women undergoing lumbosacral procedures), and 3) determine clinical risk factors
for resistance to surgical antibiotic prophylaxis in spine surgery to inform tailored approaches to selection of
antibiotic prophylaxis in spine surgery for diverse patient populations.
 These research activities are closely aligned with my career development plans. Through the team of
expert mentors assembled from anesthesiology, surgery, and molecular microbiology, I will receive training in
cutting-edge translational microbiome research and career development toward independence...

## Key facts

- **NIH application ID:** 10348358
- **Project number:** 1K23AR080209-01
- **Recipient organization:** UNIVERSITY OF WASHINGTON
- **Principal Investigator:** Dustin R Long
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $166,320
- **Award type:** 1
- **Project period:** 2022-03-15 → 2027-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10348358

## Citation

> US National Institutes of Health, RePORTER application 10348358, Targeting the Patient Microbiome for the Prevention of Surgical Site Infection in Spine Surgery (1K23AR080209-01). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10348358. Licensed CC0.

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