title: Incidence of microbiological contamination of local bone autograft used in posterior lumbar interbody fusion and its association with postoperative spinal infection.
abstract: OBJECTIVE
  The aim of this study was to examine the results of microbiological cultures from local bone autografts used in posterior lumbar interbody fusion (PLIF) and to identify their association with postoperative spinal infection.
  
  
  METHODS
  The authors retrospectively evaluated cases involving 328 patients who had no previous spinal surgeries and underwent PLIF for degenerative diseases with a minimum 1-year follow-up. Local bone was obtained during laminectomy, and microbiological culture was performed immediately prior to bone grafting. The associations between culture results from local bone autografts and postoperative spinal infections were evaluated.
  
  
  RESULTS
  The contamination rate of local bone was 4.3% (14 of 328 cases). Coagulase-negative Staphylococcus (29%) was the most common contaminant isolated, followed by Streptococcus species and methicillin-sensitive Staphylococcus aureus. Of 14 patients with positive culture results, 5 (35.7%) had postoperative spinal infections and were treated with intravenous antibiotics for a minimum of 4 weeks. One of these 5 patients also underwent reoperation for debridement during this 4-week period. Regardless of the microbiological culture results, the infection rate after PLIF with local bone autograft was 2.4% (8 of 328 cases), with 5 (62.5%) of 8 patients showing positive results on autograft culture.
  
  
  CONCLUSIONS
  The incidence of contamination of local bone autograft during PLIF was considerable, and positive culture results were significantly associated with postoperative spinal infection. Special attention focused on the preparation of local bone for autograft and its microbiological culture will be helpful for the control of postoperative spinal infection.
authors.affiliation: Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine;
authors.forename: Chong-Suh
authors.initials: CS
authors.lastname: Lee
authors.affiliation: Department of Orthopedic Surgery, Kyung Hee Medical Center, Kyung Hee University School of Medicine; and.
authors.forename: Kyung-Chung
authors.initials: KC
authors.lastname: Kang
authors.affiliation: Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine;
authors.forename: Sung-Soo
authors.initials: SS
authors.lastname: Chung
authors.affiliation: Department of Orthopedic Surgery, Kyung Hee Medical Center, Kyung Hee University School of Medicine; and.
authors.forename: Ki-Tack
authors.initials: KT
authors.lastname: Kim
authors.affiliation: Department of Orthopedic Surgery, Seoul Medical Center, Seoul, Korea.
authors.forename: Seong-Kee
authors.initials: SK
authors.lastname: Shin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D064592:Autografts / Q000382:microbiology / Q000601:surgery; D016025:Bone Transplantation / Q000009:adverse effects / Q000379:methods; D005260:Female; D006801:Humans; D015994:Incidence; D008159:Lumbar Vertebrae / Q000601:surgery*; D008161:Lumbosacral Region / Q000382:microbiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D012086:Reoperation; D012189:Retrospective Studies; D013123:Spinal Fusion / Q000379:methods; D013203:Staphylococcal Infections; D013211:Staphylococcus aureus / Q000302:isolation & purification*
keywords: CRP = C-reactive protein; ESR = erythrocyte sedimentation rate; PLIF = posterior lumbar interbody fusion; contamination; infection; local bone autograft; posterior lumbar interbody fusion