Can contamination of a patient's allograft be traced back to the allograft donor?
Cultures of allograft sites on burn patients occasionally show microbes that were not previously cultured from that patient. Our purpose was to determine 1) if microbes on allograft sites could have been transferred to the burn patient from the allograft donor and 2) if microbial transfer is different if the allograft was fresh or frozen. All allografts were cultured by the skin bank after recovery (pre-antimicrobial) and after the skin had been in an antimicrobial solution (post-antimicrobial). These culture results were compared with the results of cultures taken at the hospital from the allograft sites of burn patients. All allograft recipients at the burn hospital during 2005 were included in this Institutional Review Board approved study. Sixty-one donors provided 143 allografts for 38 patients. From the 61 donors, 114 precultures were taken; 19.5% were positive for at least one organism. Only 6.8% of 118 post-antimicrobial cultures were positive. Of the 143 allografts on burn patients, 111 were used fresh and 32 had been cryopreserved. During dressing changes, 124 cultures were taken from sites that received fresh allograft and 27 from sites that received frozen; 54.8% of cultures from fresh allograft sites and 41.5% from frozen sites (not significant, chi) were positive for microbes, which were mostly the patient's own flora. None of the microbes isolated from the burn patient allograft sites matched organisms on the pre- or post-antimicrobial cultures from the donor allografts. Regardless of whether the allografts were fresh or frozen, no instances were identified in which donor microorganisms were transferred from a donor to a recipient.
Neely
Alice N
AN
Shriners Hospitals for Children, Cincinnati, Ohio 45229, USA.
Plessinger
Ronald T
RT
Stamper
Becky
B
Kagan
Richard J
RJ
D001424:Bacterial Infections / Q000209:etiology* / Q000635:transmission; D002056:Burns / Q000601:surgery*; D006085:Graft Survival; D006801:Humans; D012189:Retrospective Studies; D012307:Risk Factors; D012867:Skin / Q000382:microbiology; D016038:Skin Transplantation / Q000009:adverse effects*; D014019:Tissue Donors; D014184:Transplantation, Homologous / Q000009:adverse effects*