Postmortem bacteriology of cadaver tissue donors: An evaluation of blood cultures as an index of tissue sterility

Martínez, Octavio; Malinin, Theodore I.; Valla, Phillip H.; Flores, Alvaro

doi:10.1016/0732-8893(85)90031-8

Cited by 42 publications

(24 citation statements)

References 11 publications

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“…Blood cultures from 14% of the allograft donors were positive, Streptococcus species being most frequently grown. This agrees with another report 13 in which a comparable percentage of blood was contaminated with organisms other than skin commensals. We are of the opinion that it is important to distinguish between allograft contamination with micro-organisms of low and high pathogenicity, as they are likely to originate from different sources.…”

Section: Discussionsupporting

confidence: 83%

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Contamination of Bone Allografts

Deijkers

Bloem

Petit

et al. 1997

The Journal of Bone and Joint Surgery. British volume

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We analysed the bacterial contamination of 1999 bone allografts retrieved from 200 cadaver donors under sterile operating conditions. The effect of various factors on the relative risk of contamination was estimated using a multiple logistic regression model.Organisms of low pathogenicity were cultured from 50% of the grafts and of high pathogenicity from 3%. The risk of contamination with low pathogenic organisms (mainly skin commensals) increased by a factor of 1.6 for each member added to the procurement team. The risk of contamination with high pathogenic organisms (mainly contaminants from the gastrointestinal tract) was 3.4 times higher in donors with a traumatic cause of death and 5.2 times higher in those with a positive blood culture. Preceding organ procurement did not significantly influence the risk of contamination. Rinsing the graft with an antibiotic solution was not an effective decontamination method.The major source of contamination is exogenous and is strongly influenced by the procurement team. Contamination from endogenous sources can be controlled by donor selection. We discuss methods that can be used to decrease contamination and the rate of discarding of bone allografts.

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Section: Discussionsupporting

confidence: 83%

“…13,17,18 We agree with this finding, the risk of contamination with high pathogenic organisms from an endogenous source in the donor having an odds ratio of 1.0 (p = 0.86). We did not notice an effect of overgrowth of micro-organisms on the skin of the donor after a prolonged time.…”

Section: Discussionsupporting

confidence: 79%

Contamination of Bone Allografts

Deijkers

Bloem

Petit

et al. 1997

The Journal of Bone and Joint Surgery. British volume

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“…Our blood sample contamination rate was 38%, and this compares favourably with other studies [13]. The majority of allograft retrieval occurred within 24 h of death.…”

Section: Discussionsupporting

confidence: 76%

“…Previous papers have identified skin organisms such as coagulase-negative Staphylococcus as the organism most commonly isolated from donated allografts [10,13]. However, organisms such as Clostridium have become particularly important following a recent study by Malinin et al [12] who showed a significant number of clostridial contamination in musculoskeletal allografts.…”

Section: Introductionmentioning

confidence: 99%

Cadaveric allograft microbiology

Ibrahim

Stafford

Esler

et al. 2004

International Orthopaedics (SICOT)

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This study aims to determine the contamination rate of cadaveric bone allograft and blood cultures retrieved from 119 donors within Leicester between 1990 and2003. A contamination rate of 27% was present, with 120 of 437 bone allografts culturing positive at the time of retrieval. Similarly, a contamination rate of 37% was present, with 40 of 107 blood samples culturing positive. The time interval between death and procurement did not influence blood contamination. Coagulase-negative Staphylococcus was the commonest organism isolated in both blood and bone cultures. One donor had Clostridium grown in their blood culture. The available evidence confirms similar contamination rates with other studies. The majority of organisms isolated were skin commensals with a low rate of contamination of highly pathogenic organisms such as Clostridium.Résumé Cette étude a pour but de déterminer le taux de contamination des allogreffes osseuses cadavériques et des hémocultures chez 119 donneurs, entre 1990 et 2003, à Leicester. Un taux de contamination de 27% était présent avec 120 des 437 allogreffes avec une culture positive au moment du prélèvement. De la même façon, un taux de contamination de 37% était présent avec 40 des 107 prélèvements de sang avec une culture le positive. L'intervalle de temps entre la mort et l'acquisition du prélèvement n'a pas influencé la contamination du sang. Le staphylocoque coagulase négative était l'organisme plus fréquent isolé dans le sang et dans l'os. Un donneur avait un Clostridium dans l'hémoculture. Les résultats confirment des taux de contamination voisins de ceux des autres études. La majorité des organismes isolés sont des commensaux de la peau avec un bas taux de contamination d'organismes hautement pathogènes tels que Clostridium.

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“…Our results resemble to those of some other studies (Martinez et al 1985, Veen 1994, Deijkers et al 1997, Bettin et al 1998, Journeaux et al 1999, although a comparison it is difficult to compare them because they used different procurement procedures and bacterial screening protocols. Microorganisms frequently found on the skin are known to be dispersed by the operating room personnel and they contaminate the grafts via air (Noble 1975).…”

Section: Discussionsupporting

confidence: 60%