title: Microbial contamination of clinical islet transplant preparations is associated with very low risk of infection.
abstract: BACKGROUND
  Several published studies have analyzed microbial contamination rates of islet products, ranging from 0% to 16%. However, few studies make reference to potential clinical consequences for transplant recipients and possible impact on islet survival.
  
  
  METHODS
  The current study defines rates of microbiological contamination of islet products under current good manufacturing practice conditions in 164 patients receiving 343 transplants at a single institution.
  
  
  RESULTS
  Nineteen (5.5%) islet preparations showed positive microbial growth with a majority (79.4%) due to Gram-positive organisms. The most frequently identified microorganism was coagulase-negative Staphylococcus (nine of 19 [47.3%]), followed by polymicrobial organisms (eight of 19 [42.1%]). No patient developed signs of clinical infection, and there were no hepatic abscesses evident on imaging by ultrasound or magnetic resonance imaging (none of 19 [0%]), despite the use of potent T-depletional induction. Finally, we could not demonstrate any negative impact of microbiological contamination on long-term islet graft survival.
  
  
  CONCLUSIONS
  Microbiological contamination of the final islet preparation appears to have little or no effect on patients or on islet survival when appropriate antibiotics are given. However, preparation sterility should be guaranteed at all cost in order maximize patient safety and avoid potential complications in immunosuppressed patients.
authors: Clinical Islet Transplant Program, University of Alberta, Edmonton, Alberta, Canada.
authors: Boris
authors: B
authors: Gala-Lopez
authors: Tatsuya
authors: T
authors: Kin
authors: Doug
authors: D
authors: O'Gorman
authors: Andrew R
authors: AR
authors: Pepper
authors: Peter
authors: P
authors: Senior
authors: Atul
authors: A
authors: Humar
authors: A M James
authors: AM
authors: Shapiro
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000276:immunology* / Q000601:surgery* / Q000628:therapy; D004866:Equipment Contamination; D005260:Female; D006085:Graft Survival / Q000276:immunology*; D006090:Gram-Negative Bacteria / Q000302:isolation & purification*; D006094:Gram-Positive Bacteria / Q000302:isolation & purification*; D006801:Humans; D016867:Immunocompromised Host; D016381:Islets of Langerhans Transplantation / Q000276:immunology* / Q000379:methods; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D018579:Patient Selection; D018570:Risk Assessment; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents