title: Autotransfusion--bacterial contamination during hip arthroplasty and efficacy of cefuroxime prophylaxis. A randomized controlled study of 40 patients.
abstract: 40 patients undergoing primary hip arthroplasty, given autologous processed blood transfusion, were randomized a receive no antibiotic prophylaxis (group A, n 20) or cefuroxime (1.5 g single injection; group B, n 20). Bacterial contamination at various steps in the autotransfusion procedure was assessed in liquid and solid culture media. The operation field and the wound drainage blood were never contaminated either of the groups but some of the suction tips were. Parts of the Vacufix blood collection bags of group A contained bacteria, but none in group B. Processed red blood cell concentrates in both groups showed bacterial growth. Greater blood loss did not increase the contamination rate in general. Isolated bacteria included the species Staphylococcus epidermidis, coagulase-negative staphylococci and Propionibacteria in both groups, but with different cell counts. In addition, Corynebacterium bovis et minutissimum and Moraxelle were identified in group A. In conclusion, autologous blood transfusion was a safe procedure. If contamination occurred, the bacterial count was low, and the bacteria of low pathogenicity. Antibiotic prophylaxis with cefuroxime reduced this contamination of suction tips and collection bags and limited the transfer of autologous blood products.
authors.affiliation: Department of Anesthesiology/Intensive Care, Rehabilitation Hospital, University of Ulm, Germany.
authors.forename: K H
authors.initials: KH
authors.lastname: Wollinsky
authors.forename: M
authors.initials: M
authors.lastname: Oethinger
authors.forename: M
authors.initials: M
authors.lastname: Büchele
authors.forename: P
authors.initials: P
authors.lastname: Kluger
authors.forename: W
authors.initials: W
authors.lastname: Puhl
authors.forename: H H
authors.initials: HH
authors.lastname: Mehrkens
mesh_terms: D019072:Antibiotic Prophylaxis / Q000379:methods*; D001419:Bacteria / Q000302:isolation & purification; D001424:Bacterial Infections / Q000097:blood / Q000209:etiology / Q000517:prevention & control; D016063:Blood Loss, Surgical / Q000517:prevention & control; D001804:Blood Transfusion, Autologous / Q000009:adverse effects* / Q000295:instrumentation; D002444:Cefuroxime / Q000627:therapeutic use*; D002511:Cephalosporins / Q000627:therapeutic use*; D004866:Equipment Contamination; D004906:Erythrocyte Count; D005260:Female; D006622:Hip Prosthesis / Q000379:methods*; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012449:Safety; D013530:Surgical Wound Infection / Q000097:blood / Q000382:microbiology / Q000517:prevention & control*
chemical_list: D002511:Cephalosporins; D002444:Cefuroxime