User menu

Accès à distance ? S'identifier sur le proxy UCLouvain

Analysis of predisposing factors for contamination of bone and tendon allografts.

Primary tabs

Schubert, Thomas [UCL] Bigare, Elisa [UCL] Van Isacker, Tom [UCL] Gigi, Jacques [UCL] Delloye, Christian [UCL] Cornu, Olivier [UCL]

Bone and tissue allografts are widely used in transplantation. The increasing demand for safe allografts must be met, while minimizing disease transmission. We analysed the incidence and potential risk factors of allograft contamination and the effectiveness of disinfection, by reviewing 22 years of tissue bank activity and 474 donor procurements. We also compared different disinfection procedures used over the 22 years. The overall contamination rate was 10.1%. Risk factors were related to the donor or procurement method. Immediate culture at the tissue recovery site diminished the rate of false positives by reducing later sample manipulation. High-virulence allograft contamination was mainly related to donor factors, while low-virulence contamination was related to procurement methods. Analysis of donor-related risk factors showed no statistical differences for age, sex, or cause of death. An intensive care unit stay was associated with less contamination with high-virulence microbes. Procurement in a setting other than an operating theatre was associated with higher contamination rate. Team experience reduced contamination. Pelvic and tendon allografts were most frequently contaminated. Proper disinfection considerably reduced the contamination rate to 3.6%. We conclude that procurement must be performed under aseptic conditions, with short delays, and by trained personnel. Grafts should be disinfected and packed as soon as possible.

Document type Article de périodique (Journal article) – Article de recherche
Access type Accès restreint
Publication date 2012
Language Anglais
Journal information "Cell and Tissue Banking" - Vol. 13, no. 3, p. 421-429 (2012)
Peer reviewed yes
Publisher Springer Netherlands ((Netherlands) Dordrecht)
issn 1389-9333
e-issn 1573-6814
Publication status Publié
Affiliations UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur
UCL - SSS/IREC/CARS - Computer Assisted Robotic Surgery
UCL - (SLuc) Service de microbiologie
Links
  1. Anastasescou M., Cornu O., Banse X., König J., Hassoun A., Delloye C., Ethanol treatment of tendon allografts: a potential HIV inactivating procedure, 10.1007/s002640050253
  2. Barrios RH, Leyes M, Amillo S, Oteiza C (1994) Bacterial contamination of allografts. Acta Orthop Belg 60:293–295
  3. Best A.J., Nixon M.F., Taylor G.J.S., Brief exposure of 0.05% chlorhexidine does not impair non-osteoarthritic human cartilage metabolism, 10.1016/j.jhin.2007.05.014
  4. Bettin D., Dethloff M., Steinbeck J., Polster J., Organisation einer Knochen- und Gewebebank, 10.1055/s-2008-1039468
  5. Bettin Dieter, Harms Claus, Polster Jiirgen, Niemeyer Thomas, High incidence of pathogenic microorganisms in bone allografts explanted in the morgue, 10.3109/17453679809000937
  6. Bohatyrewicz A., Bohatyrewicz R., Klęk R., Kamiński A., Dobiecki K., Białecki P., Kędzierski M., Zienkiewicz M., Dziedzic-Gocławska A., Factors Determining the Contamination of Bone Tissue Procured from Cadaveric and Multiorgan Donors, 10.1016/j.transproceed.2005.11.087
  7. Camiade Christophe, Goldschmidt Pablo, Koskas Fabien, Ricco Jean-Baptiste, Jarraya Mohamed, Gerota Jean, Kieffer Edouard, Optimization of the Resistance of Arterial Allografts to Infection: Comparative Study with Synthetic Prostheses, 10.1007/s100160010051
  8. Deijkers R. L. M., Bloem R. M., Petit P. L. C., Brand R., Vehmeyer S. B. W., Veen M. R., Contamination Of Bone Allografts: Analysis Of Incidence And Predisposing Factors, 10.1302/0301-620x.79b1.7137
  9. Delloye C (2000) Bone banking in orthopaedic surgery. 55-020-E-10, Editions Scientifiques et Medicales Elsevier SAS, Paris
  10. Delloye C, De Halleux J, Cornu O, Wegmann E, Buccafusca GC, Gigi J (1991) Organizational and investigational aspects of bone banking in Belgium. Acta Orthop Belg 57(2):27–34
  11. Eastlund Ted, Bacterial infection transmitted by human tissue allograft transplantation, 10.1007/s10561-006-0003-z
  12. European Association of Musculoskeletal Transplantation (1997) Common standards for musculo-skeletal tissue banking. Vienna
  13. Hope PG, Kristinsson KG, Norman P, Elson RA (1989) Deep infection of cemented total hip arthroplasty caused by coagulase-negative staphylococci. J Bone Jt Surg Br 5:851–855
  14. Ibrahim T., Stafford H., Esler C. N. A., Power R. A., Cadaveric allograft microbiology, 10.1007/s00264-004-0579-5
  15. Graves S C, Mann R A, Graves K O, Triple arthrodesis in older adults. Results after long-term follow-up. : , 10.2106/00004623-199303000-00006
  16. Jekeler L.-N., Thiéry J., Ligamentoplastie du croisé antérieur par allogreffe tendineuse congelée mixte intra- et extra-articulaire, 10.1016/s0035-1040(04)70726-6
  17. Journeaux Simon F., Johnson Nigel, Bryce Sharon L., Friedman Shep J., Sommerville Scott M.M., Morgan David A.F., Bacterial contamination rates during bone allograft retrieval, 10.1016/s0883-5403(99)90222-x
  18. Kälicke Thomas, Schierholz Jörg, Schlegel Urs, Frangen Thomas Manfred, Köller Manfred, Printzen Gert, Seybold Dominik, Klöckner Stefan, Muhr Gert, Arens Stephan, Effect on infection resistance of a local antiseptic and antibiotic coating on osteosynthesis implants: An in vitro and in vivo study, 10.1002/jor.20193
  19. Langone Anthony J., Helderman J. Harold, Disparity between Solid-Organ Supply and Demand, 10.1056/nejme038117
  20. Lord C F, Gebhardt M C, Tomford W W, Mankin H J, Infection in bone allografts. Incidence, nature, and treatment. : , 10.2106/00004623-198870030-00008
  21. Malinin TI, Martinez OV, Brown MD (1985) Banking of massive osteoarticular and intercalary bone allografts-12 years’ experience. Clin Orthop Relat Res 197:44–57
  22. Malinin T. I., Buck B. E., Temple H. T., Martinez O. V., Fox W. P., Incidence of clostridial contamination in donors' musculoskeletal tissue, 10.1302/0301-620x.85b7.14438
  23. Martinez Octavio V., Buck Billy E., Hernandez Maribel, Malinin Theodore, Blood and Marrow Cultures as Indicators of Bone Contamination In Cadaver Donors : , 10.1097/01.blo.0000053343.97749.21
  24. Matas Arthur J., The Importance of Innovative Efforts to Increase Organ Donation, 10.1001/jama.294.13.1691
  25. Raad I., Reitzel R., Jiang Y., Chemaly R. F., Dvorak T., Hachem R., Anti-adherence activity and antimicrobial durability of anti-infective-coated catheters against multidrug-resistant bacteria, 10.1093/jac/dkn281
  26. Reading A. D., Rooney P., Taylor G. J. S., Quantitative assessment of the effect of 0.05% chlorhexidine on rat articular cartilage metabolismin vitro andIn vivo, 10.1002/jor.1100180513
  27. Saegeman V. S. M., Ectors N. L., Lismont D., Verduyckt B., Verhaegen J., Effectiveness of antibiotics and antiseptics on coagulase-negative staphylococci for the decontamination of bone allografts, 10.1007/s10096-009-0715-7
  28. Sanzén Lennart, Walder Mats, Antibiotic resistance of coagulase-negative staphylococci in an orthopaedic department, 10.1016/0195-6701(88)90132-6
  29. Segur J. M., Suso S., García S., Combalía A., Ramón R., Bone allograft contamination in multiorgan and tissue donors, 10.1007/s004020050337
  30. Segur Josep M., Suso Santiago, García Sebastián, Combalía Andrés, Fariñas Oscar, Llovera Antoni, 10.1023/a:1010136931919
  31. Tomford W W, Transmission of disease through transplantation of musculoskeletal allografts. : , 10.2106/00004623-199511000-00017
  32. Tomford WW, Doppelt SH, Mankin HJ, Friedlaender GE (1983) 1983 bone bank procedures. Clin Orthop Relat Res 174:15–21
  33. Tomford W W, Thongphasuk J, Mankin H J, Ferraro M J, Frozen musculoskeletal allografts. A study of the clinical incidence and causes of infection associated with their use. : , 10.2106/00004623-199072080-00003
  34. Tunney MM, Ramage G, Patrick S, Nixon JR, Murphy PG, Gorman SP (1998) Antimicrobial susceptibility of bacteria isolated from orthopedic implants following revision hip surgery. Antimicrob Agents Chemother 11:3002–3005
  35. Van Huyssteen A. L., Bracey D. J., Chlorhexidine and chondrolysis in the knee, 10.1302/0301-620x.81b6.9719
  36. Veen MR (1994) Bone allografts. A study into bacterial contamination, sensitivity of cultures, decontamination, and contribution to postoperative infection. Thesis, Leiden University
  37. Veen MR, Bloem R, Petit P (1994) Sensitivity and negative predictive value of swab cultures in Musculoskeletal allograft procurement. Clin Orthop Relat Res 300:259–263
  38. Vehmeyer Stephan, Wolkenfelt Julius, Deijkers Ruud, Petit Pieter, Brand Ronald, Bloem Rolf, Bacterial contamination in postmortem bone donors, 10.1080/000164702321039679
  39. Witsø Eivind, Persen Leif, Løseth Kirsti, Bergh Kåre, Adsorption and release of antibiotics from morselized cancellous bone in vitro studies of 8 antibiotics, 10.3109/17453679908997812
  40. Witsø Eivind, Persen Leif, Benum Pål, Bergh Kåre, Cortical allograft as a vehicle for antibiotic delivery, 10.1080/17453670510041457
Bibliographic reference Schubert, Thomas ; Bigare, Elisa ; Van Isacker, Tom ; Gigi, Jacques ; Delloye, Christian ; et. al. Analysis of predisposing factors for contamination of bone and tendon allografts.. In: Cell and Tissue Banking, Vol. 13, no. 3, p. 421-429 (2012)
Permanent URL http://hdl.handle.net/2078.1/123441