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Journal of Bone and Joint Surgery - British Volume, Vol 85-B, Issue 7,
1051-1054.
doi: 10.1302/0301-620X.85B7.14438 Copyright © 2003 by British Editorial Society of Bone and Joint Surgery Incidence of clostridial contamination in donors’ musculoskeletal tissueT. I. Malinin, MD, Professor of Orthopaedics and Rehabilitation; B. E. Buck, MD, Clinical Associate Professor of Orthopaedics and Rehabilitation; H. T. Temple, MD, Professor of Orthopaedics and Rehabilitation; and O. V. Martinez, PhD, Research Associate Professor of Orthopaedics and RehabilitationTissue Bank, Department of Orthopaedics and Rehabilitation, University of Miami School of Medicine, PO Box 016960 (R-12), Miami, Florida 33101, USA. W. P. Fox, PhD, Professor and Chairman Department of Mathematics, Francis Marion University, 5130 East Palmetto, Florence, South Carolina 29506, USA. Correspondence should be sent to Professor T. I. Malinin. Reports of infection by Clostridium sordellii associated with allograft transplantation have generated considerable interest. We report our experience in recognising clostridial contamination in cadaver donors of musculoskeletal tissue. Tissues obtained from 795 consecutive donors were excised using standard surgical techniques. Samples of blood and bone marrow were also obtained. Donors with clostridia recovered from any site were matched with the preceding donor without clostridia as a procedural and environmental control. The histories of the donors were analysed to determine which variables had a relationship to contamination by running a contingency table and chi-squared test on the variables against the event of a donor being contaminated. Sixty-four donors (8.1%) had clostridia, most commonly C. sordellii. Clostridia were grown from the blood, marrow and tissue samples of 52, 37 and 30 donors, respectively. In eight cases, they were cultured from the tissue samples alone. There was no significant difference in age or gender between the contaminated donors and the control group. Open wounds were more common in control than in contaminated subjects, but only death by drowning in the contaminated group was statistically significant (p = 0.02). The time between death and the excision of tissue which was contaminated (16 hrs 10 mins) compared with control (11 hrs 10 mins) donors was also significant (p < 10–6). We conclude that there is clostridial contamination in a significant number of tissue donors, particularly with increasing time between death and tissue excision. Among the most commonly encountered species is C. sordellii. Multiple microbiological cultures, including blood, are necessary in order to identify clostridial contamination. This article has been cited by other articles:
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