Analysis of potential contamination factors in musculoskeletal tissues
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Analysis of potential contamination factors in musculoskeletal tissues Guilherme G. Naves . Andre´ F. Silva . Uri Antebi . Priscila C. Cristovam . Emerson K. Honda . Rodrigo P. Guimara˜es
Received: 28 May 2018 / Accepted: 25 July 2018 Ó Springer Nature B.V. 2018
Abstract Tissue Banks have become the main source for bone grafts, due to preference for homologous tissues. Notwithstanding the use of aseptic techniques for procurement of tissues and judicious selection of donors, microorganisms are frequently found in procured bones. Purpose of this study is to evaluate the factors that increase safety of procurement and minimize discard of procured tissues. Microbiological contamination was analyzed in 1271 musculoskeletal tissues removed from 138 multiorgan donors over a period extending from 2006 to 2016. Effects of various risk factors related with
G. G. Naves E. K. Honda R. P. Guimara˜es (&) Department of Orthopedics and Traumatology, College of Medicine of Santa Casa de Sa˜o Paulo, Rua Barata Ribeiro, 380, Sa˜o Paulo, SP 01308-000, Brazil e-mail: [email protected] G. G. Naves e-mail: [email protected] E. K. Honda e-mail: [email protected] G. G. Naves A. F. Silva U. Antebi P. C. Cristovam E. K. Honda R. P. Guimara˜es Salvador Arena Tissue Bank, Irmandade da Santa Casa de Miserico´rdia de Sa˜o Paulo, Sa˜o Paulo, Brazil e-mail: [email protected]
contamination were estimated using a logistic regression model. Microbiological contamination rate in the tissues was 17.1%; low pathogenic microorganisms were cultivated in 12.9% of the tissues, while highly pathogenic ones were cultivated in 4.2% of the tissues. Evolution of one single team was monitored during that period, verifying a fall in the general contamination level from 22.5 to 9.2%. Absence of antibiotics increased low pathogenic contamination risk. Every additional day in intensive care unit (ICU) increased the risk of highly pathogenic contamination. Time elapsed between death and the beginning of removal procedures was found to be relevant for both low pathogenic and highly pathogenic microorganisms. Among the studied factors, the following contributed for a significant increase in contamination by microorganisms in removed tissues: lack of use of prophylactic antibiotic therapy in donors, quantity of removed tissues, length of admission in ICU and the time elapsed between aortic clamping and beginning of the removal procedure. Keywords Bone allograft Microbiological contamination Tissue Bank Tissue donor Tissue contamination Procurement of tissues
U. Antebi e-mail: [email protected] P. C. Cristovam e-mail: [email protected]
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Cell Tissue Bank
Introduction Need for replacement of musculoskeletal tissue due to losses caused by various situations is an ever-growing issue in surgical practice. With greater longevity of the population, as well as higher numbers of surgical indications for young patients, the quest for lasting solutions leads to the employme
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