Culture methods of allograft musculoskeletal tissue samples in Australian bacteriology laboratories
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ORIGINAL PAPER
Culture methods of allograft musculoskeletal tissue samples in Australian bacteriology laboratories Kerry Varettas
Received: 4 June 2012 / Accepted: 28 December 2012 / Published online: 13 January 2013 Ó Springer Science+Business Media Dordrecht 2013
Abstract Samples of allograft musculoskeletal tissue are cultured by bacteriology laboratories to determine the presence of bacteria and fungi. In Australia, this testing is performed by 6 TGA-licensed clinical bacteriology laboratories with samples received from 10 tissue banks. Culture methods of swab and tissue samples employ a combination of solid agar and/or broth media to enhance microorganism growth and maximise recovery. All six Australian laboratories receive Amies transport swabs and, except for one laboratory, a corresponding biopsy sample for testing. Three of the 6 laboratories culture at least one allograft sample directly onto solid agar. Only one laboratory did not use a broth culture for any sample received. An international literature review found that a similar combination of musculoskeletal tissue samples were cultured onto solid agar and/or broth media. Although variations of allograft musculoskeletal tissue samples, culture media and methods are used in Australian and international bacteriology laboratories, validation studies and method evaluations have challenged and supported their use in recovering fungi and aerobic and anaerobic bacteria.
K. Varettas (&) South Eastern Area Laboratory Services, Microbiology Department, CSB Level 3, The St. George Public Hospital, Gray St, Kogarah, Sydney, NSW 2217, Australia e-mail: [email protected]
Keywords Allograft Bioburden Contamination Culture Musculoskeletal Introduction Samples of musculoskeletal tissue from allografts are sent to bacteriology laboratories for determination of the bacterial and fungal bioburden. The aseptic technique of retrieving musculoskeletal tissue from living and cadaveric donors in operating theatres and morgues is performed to minimise the risk of contamination from external sources (Schubert et al. 2012). It does not reduce the microbial bioburden that may already be present in the tissue. In Australia, there are six clinical bacteriology laboratories licensed by the Therapeutic Goods Administration (TGA 2000) to provide bioburden assessment of samples of allograft musculoskeletal tissue sent from ten tissue banks (Health Outcomes International Pty Ltd. October 2009; Varettas 2012). The bacterial and fungal culture methods used by Australian bacteriology laboratories have not been previously described. This paper summarises the current culture methods in use in TGAlicensed clinical bacteriology laboratories in Australia as well as a literature review of international methods. Bacteriological media used in culture methods Traditionally, culture methods for musculoskeletal allograft samples received in the bacteriology
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laboratory have employed a selection of solid agar and/ or broth media to initially enhance micro-or
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