Bacterial infections associated with allogenic bone transplantation

Abstract

© 2015, Institut za Vojnomedicinske Naucne Informacije/Documentaciju. All Rights Reserved. Background/Aim. Bone allografts are frequently used in or-thopedic reconstructive procedures carrying a high risk for re-cipients. To assess the nature and frequency of allograft con-tamination and associated surgical infection the case records from our institutional bone bank were reviewed. Methods. We retrospectively analyzed the microbiology of discarded bone al-lografts and the surgical site of the recipients. A case series of patients who acquired surgical site infection after allogenic bone transplantation was presented. Swab culturing was con-ducted on 309 femoral heads from living donors who under-went partial and total hip arthroplasty between January 2007 and December 2013. To prevent potential bone allograft con-tamination we used saline solution of 2.0 mg/ml of amikacin during thawing. The overall infection rate was analyzed in 197 recipients. Results. Of the 309 donated femoral heads, 37 were discarded due to bacterial contamination, giving the overall contamination rate of 11.97%. The postoperative survey of 213 bone allotransplantations among 197 recipients showed the in-fection rate of 2.03%. The coagulase-negative Staphylococcus was the most commonly identified contaminant of bone allografts and recipient surgical sites. Conclusion. The allograft con-tamination rate and the infection rate among recipients in our institution are in accordance with the international standards. The coagulase-negative Staphylococcus was the most commonly identified contaminant of bone allografts and recipient surgical sites. There is no strong evidence that surgical site infections were associated with bone allograft utilization. We plan further improvements in allograft handling and decontamination with highly concentrated antibiotic solutions in order to reduce in-fection risk for recipients.