Microbiological examination of donated human cardiac tissue in heart valve banking

Kats, Jorge P. van; Tricht, Corina van; Dijk, Alice van; Schans, Michel van der; Bogaerdt, Antoon van den; Petit, P. L. C.; Bogers, Ad J.J.C.

doi:10.1016/j.ejcts.2009.07.011

Cited by 36 publications

(23 citation statements)

References 22 publications

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“…The data of the current study show that the initial tissue contamination rate and the microbes' spectrum are comparable to that of the previous reports from our and other cardiovascular tissue banks (Jashari et al 2007;van Kats 2010). Again the initial contamination rate of the arterial tissues was significantly higher than that of the heart tissues.…”

Section: Discussionsupporting

confidence: 92%

“…To prevent bacterial transmission to allografts' recipients, decontamination is thus an important procedure commonly practiced in the tissue banks around the world (van Kats et al 2010;Ireland and Spelman 2005;Gulbins et al 2003;Dacey 2000). Although the setting of antibiotic treatment does have a significant impact on decontamination success, to date, no consensus exists on an optimal formula.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of decontamination process of heart valve and artery tissues in European Homograft Bank (EHB): a retrospective study of 1,055 cases

Fan¹,

Hoeck²,

Holovska³

et al. 2011

Cell Tissue Bank

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To evaluate the efficiency of decontamination practice in European Homograft Bank (EHB), the data of the cardiovascular tissues received during recent 2 years were retrospectively analysed in this study. After initial assessment, the tissues were incubated in a 3-antibiotics' cocktail at 4°C for 20-48 h. The states of contamination were evaluated before and after incubation with the focus on the differences in donor type, tissue type, germ type and incubation time. Amongst 1,055 eligible tissues, 77.2% were hearts and 22.8% were arteries. 82.2% of the tissues were retrieved from the multi-organ donors (MOD), 15.4% from the recipients of heart transplantation (RHT) and 2.4% from the non-heart beating donors (NHBD). The initial contamination rate was 27.4% with a significantly higher incidence in arteries. The RHT tissues had the lowest contamination rate comparing to that of MOD and NHBD. Staphylococcus species was the major source of contamination. After antibiotic incubation, 76.8% of the contaminated tissues were disinfected, which was significantly higher for the hearts than the arteries. The RHT tissues had the highest decontamination rate than that of MOD and NHBD tissues. Propionibacterium acnes was detected in 48.1% of the remaining contaminated cases. The average incubation time of the Propionibacterium-positive tissues was significantly shorter than that of decontaminated tissues. In conclusion, the current decontamination protocol of EHB is sufficient for most of the initially contaminated bacteria, whereas it is inadequate for Propionibacterium acnes. This may be related to the slow-growing nature of this bacterium and thereby the relative shorter antibiotic incubation time.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Evaluation of decontamination process of heart valve and artery tissues in European Homograft Bank (EHB): a retrospective study of 1,055 cases

Fan¹,

Hoeck²,

Holovska³

et al. 2011

Cell Tissue Bank

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“…A differential effect of the culture medium was noted by van Kats et al (2010) in a study of heart valve biopsies. The transport medium was inoculated both into blood culture vials (FA and FN blood culture media, BacT/Alert; bioMérieux) and thioglycolate broth.…”

Section: Culture Mediamentioning

confidence: 99%

Optimizing culture methods for diagnosis of prosthetic joint infections: a summary of modifications and improvements reported since 1995

Larsen

Lange

et al. 2012

Journal of Medical Microbiology

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Improving diagnosis of prosthetic joint infections (PJIs) has become an increasing challenge due to a steadily rising number of patients with prosthetic implants. Based on a systematic literature search we have ascertained the evidence base for improvement of culture diagnosis. We searched PubMed/MEDLINE using the medical subject heading (MeSH) 'prosthesis-related infections' 1995 through 2010 without further restrictions. An analogous search was conducted for ISI Web of Knowledge. A total of 1409 reports were screened for original results, obtained by methods described in sufficient detail to make replication possible. We gave priority to methods for sample preparation, culture media, culture methods and incubation time. Clinical sensitivity and specificity were calculated where possible. We found evidence to support superiority of cultures obtained from the diluent after sonication of prosthetic implants in comparison with culturing tissue biopsies. Sonication parameters and accessory steps have been studied extensively, and thresholds for significant growth have been defined. Conversely, methods for processing of soft tissue biopsies have been studied to a limited extent. Culture of synovial fluid in blood culture vials has been shown to be more sensitive (90-92 %) than intraoperative swab cultures (68-76 %) and tissue cultures (77-82 %). Formal evaluation of agar media for culturing PJI specimens seemed to be lacking. The polymicrobial nature of PJIs supports the routine use of an assortment of media suitable for recovery of fastidious, slow-growing, anaerobic and sublethally damaged bacteria. A number of studies supported an incubation period for up to 14 days. Although we identified evidence-based improvements of culture methods, there is a need for more studies especially with regard to tissue biopsies. Culturing remains an important means to identify and characterize pathogenic micro-organisms and supplements the increasing number of cultureindependent assays.

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“…Microbiological decontamination techniques include chemical and antibiotic treatments [10–12] or terminal sterilization methods to target microorganisms [13–14]. European Directive 2006/86/EC requires that tissue banks specify, document and validate a microbial inactivation procedure for the decontamination of donor tissues [15]. Focusing on antibiotic treatments, tissue banks adopt cocktail solutions of various compounds with antimicrobial activity.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of allograft decontamination with two different antibiotic cocktails at the Treviso Tissue Bank Foundation

et al. 2018

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Microbiological contamination of retrieved tissues is a critical aspect of allograft safety and tissue banks must continuously implement decontamination procedures to minimize tissue contamination. In this study we compared the decontamination efficacy of a new antibiotic cocktail (cocktail B: BASE medium with Gentamicin, Meropenem and Vancomycin) with the cocktail previously adopted at Treviso Tissue Bank Foundation (FBTV) (cocktail A: RPMI medium with Ceftazidime, Lincomycin, Polymyxin B and Vancomycin). Two decontamination steps were carried out, the first immediately after retrieval, the second after processing. The contamination rate was calculated before processing (Time 1) and cryopreservation (Time 2) for total tissues, musculoskeletal tissues and cardiovascular tissues, and the bacterial species involved were analyzed. Cocktail A was used to decontaminate 3548 tissues, of which 266 were cardiovascular and 3282 musculoskeletal tissues. For cocktail A, total tissue contamination was 18.6% at Time 1 and 0.9% at Time 2, with 15.7% contaminated musculoskeletal tissues at Time 1 and 0.4% at Time 2, respectively, while cardiovascular tissues were 50% contaminated at Time 1 and 6.4% at Time 2. Cocktail B was used to decontaminate 3634 tissues of which 318 were cardiovascular and 3316 musculoskeletal tissues. For cocktail B, total tissue contamination was 8.6% at Time 1 and 0.2% at Time 2, with 7.6% contaminated musculoskeletal tissues at Time 1 and 0.03% at Time 2, respectively. Contamination of cardiovascular tissues was 20.4% at Time 1 and 1.9% at Time 2. Intergroup and intragroup contamination rates decreased statistically significantly (p<0.05). Our results have shown that cocktail B was more effective than cocktail A in killing bacteria in both cardiovascular and musculoskeletal tissues during the two decontamination cycles.

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Microbiological examination of donated human cardiac tissue in heart valve banking

Cited by 36 publications

References 22 publications

Evaluation of decontamination process of heart valve and artery tissues in European Homograft Bank (EHB): a retrospective study of 1,055 cases

Evaluation of decontamination process of heart valve and artery tissues in European Homograft Bank (EHB): a retrospective study of 1,055 cases

Optimizing culture methods for diagnosis of prosthetic joint infections: a summary of modifications and improvements reported since 1995

Evaluation of allograft decontamination with two different antibiotic cocktails at the Treviso Tissue Bank Foundation

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