The researchers also found that the operations associated with the greatest risk of infection - lymph-node biopsy, soft-tissue-mass excision and abscess-drainage cases - were often assigned to the most inexperienced surgeons-in-training, placing them at greatest risk.
"Sharpless surgical techniques combined with traditional precautions and early education for surgery trainees are the most practical ways to reduce the risk of infection to health care workers," said Makary.
The researchers studied 709 consecutive adult general surgery operations performed between July 2003 and June 2004 in the community surgical service at The Johns Hopkins Hospital including inpatient, emergency department and outpatient surgical procedures. Data were collected on HIV, hepatitis B and hepatitis C test results, type of operation, age, sex and history of intravenous drug use.
The researchers found that 38 percent of all operations involved a bloodborne pathogen, and almost half (47 percent) of all men tested positive for at least one infection. HIV accounted for 26 percent of infections, hepatitis B for 4 percent, hepatitis C for 35 percent, and co-infection with HIV and hepatitis C accounted for 17 percent of infections. In addition, bloodborne pathogen infection was found in up to 65 percent of patients with a history of intravenous drug use and in as many as 71 percent of patients undergoing a soft-tissue abscess procedure or lymph-node biopsy.
While the patients in this study tend toward low socioeconomic status and increased substance use, most university hospitals in the United States are located in urban areas and serve a similar patient population, added Makary.
Other authors on the report are Eric S. Weiss, Theresa Wang, Dora Syin, Peter Pronovost, David Chang and Edward Cornwell III.