Bacterial contamination in postmortem bone donors

Abstract

We analyzed factors influencing the contamination rate of allografts and blood samples obtained from postmortem bone donors. 5,710 allografts were harvested, from 550 donors of which 3,164 (55%) were swab culture negative. Blood cultures were positive in 140 donors (26%). The risk of graft contamination increased with each extra team member (Odds Ratio 1.9). It was also higher with organisms of greater virulence in donors with a positive blood culture (OR 3.5). The risk of blood contamination increased per hour postmortem (OR 1.1) and the same increase was seen with organisms of high virulence. In donors with multiple trauma, the risk of blood contamination with organisms of high virulence was greater (OR 8.2), but smaller in donors with preceding organ procurement (OR 0.1). To minimize the bacterial load, donors should be obtained in operating rooms, using aseptic techniques with only a few personnel for procurement. The postmortem time should be kept to a minimum. The procurement cultures from donors with multiple trauma should be carefully interpreted. Blood cultures should be taken into account, since these can help to find contamination not detected by swab cultures.

Infection not associated with use of human musculoskeletal tissue allografts

“…Journeaux et al (1999) determined that contamination rates of harvested tissue were 13% in femoral heads gathered from living donors and 35% in musculoskeletal allografts removed from cadaveric donors. These rates parallel those in other studies that evaluated contamination rates in living and cadaveric donor musculoskeletal allografts Martinez et al 2003;Vehmeyer et al 1999Vehmeyer et al , 2002. The incidence of Clostridium species contamination of tissue allografts obtained from cadaveric sources has ranged from 1% to 8% Ibrahim et al 2004;Martinez et al 2003), although the clinical significance of this rate is uncertain.…”

Contamination of tissue allografts from a deceased donor through haematic dissemination: a case study

“…The most widely used approach to perform a microbiological test of a recovered allograft is taking tissue samples during surgery for a culture (Bohatyrewicz et al 2006;Forsell and Liesman 2000;Journeaux et al 1999;Vehmeyer et al 2001). The most frequently cultivated microorganisms in samples of bone or tendinous allografts are often bacteria with a low virulence level, mainly cutaneous flora, which are thought to come from the donors themselves or by contamination from the extracting equipment (Deijkers et al 1997;Vehmeyer et al 2002).…”

“…In their research, several authors, mainly Vehmeyer et al (Deijkers et al 1997;Vehmeyer et al 2001Vehmeyer et al , 2002, have additionally acquired hemocultures so as to rule out the presence of pathogenic microorganisms in the donor's blood. In most research in which there are both bone and hemoculture samples, the highest bacteria contamination levels are found in the latter (Deijkers et al 1997;Ibrahim et al 2004;Vehmeyer et al 2002).…”

Sterilization of Allograft Bone: is 25 kGy the Gold Standard for Gamma Irradiation?

“…1). In living donors, contamination rates range from 2.7% to 22% (Hou et al 2005;Journeaux et al 1999;Liu et al 2002;Sommerville et al 2000;Sutherland et al 1997;Vehmeyer et al 2002b), while in cadaveric donors, this rate varies from 6.6% to 53% (Barrios et al 1994;Deijkers et al 1997;Journeaux et al 1999;Liu et al 2002;Vehmeyer et al 2002a), much higher than that from living donors. These rates of bacterial contamination from bone allografts provide a rationale for regulatory agencies to require terminal sterilization.…”