title: Influence of Gelatin-Thrombin Matrix Tissue Sealant on Bacterial Colony Formation and Risk of Pelvic Infection.
abstract: Objective. Gelatin-thrombin matrix (GTM) tissue sealant use was previously identified as an independent predictor of pelvic infection following hysterectomies. We aim to elucidate contributing factors by assessing influence of GTM on bacterial colony formation and characterizing bacteria present at the vaginal cuff. Methods. Escherichia coli was incubated in phosphate-buffered saline (PBS) and pelvic washings with and without GTM to assess influence on colony formation. Pelvic washings of the vaginal cuff were collected from hysterectomies occurring from June through October 2015. In vitro techniques, 16S rRNA gene qPCR, and 16S amplicon sequencing were performed with washings to characterize bacteria at the vaginal cuff. Results. Mean bacterial colony formation in PBS was greater for E. coli incubated in the presence of GTM (1.48 × 10(7) CFU/mL) versus without (9.95 × 10(5) CFU/mL) following 20-hour incubation (p = 0.001). Out of 61 pelvic washings samples, 3 were culture positive (≥5000 CFU/mL) with Enterococcus faecalis. Conclusion. In vitro experiments support a facilitating role of GTM on colony formation of E. coli in PBS. However, given the negative results of surgical site washings following adequate disinfection, the role of GTM in promoting posthysterectomy pelvic infections may be limited. Analysis of pelvic washings revealed presence of E. faecalis, but results were inconclusive. Further studies are recommended.
authors.affiliation: Research Track, University of Colorado School of Medicine, Aurora, CO 80045, USA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Jarrett
authors.affiliation: Department of Immunology and Microbiology, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO 80045, USA.
authors.forename: Andres
authors.initials: A
authors.lastname: Vázquez-Torres
authors.affiliation: Division of Infectious Diseases, Department of Medicine, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO 80045, USA.
authors.forename: Daniel N
authors.initials: DN
authors.lastname: Frank
authors.affiliation: Division of Infectious Diseases, Department of Medicine, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO 80045, USA.
authors.forename: Bruce D
authors.initials: BD
authors.lastname: McCollister
authors.affiliation: Research Track, University of Colorado School of Medicine, Aurora, CO 80045, USA.
authors.forename: Patrick K
authors.initials: PK
authors.lastname: Henthorn
authors.affiliation: Division of Infectious Diseases, Department of Medicine, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO 80045, USA.
authors.forename: Diana
authors.initials: D
authors.lastname: Ir
authors.affiliation: Division of Family Planning, Department of OB/GYN, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO 80045, USA.
authors.forename: Jeanelle
authors.initials: J
authors.lastname: Sheeder
authors.affiliation: Division of Gynecologic Oncology, Department of OB/GYN, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO 80045, USA.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Guy
authors.affiliation: Division of Gynecologic Oncology, Department of OB/GYN, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO 80045, USA.
authors.forename: Hiba Q
authors.initials: HQ
authors.lastname: Anwar
authors.affiliation: Division of Gynecologic Oncology, Department of OB/GYN, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO 80045, USA.
authors.forename: Kian
authors.initials: K
authors.lastname: Behbakht
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015169:Colony Count, Microbial; D004926:Escherichia coli / Q000302:isolation & purification; D005260:Female; D005780:Gelatin; D006488:Hemostasis, Surgical / Q000009:adverse effects / Q000379:methods; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects*; D008875:Middle Aged; D034161:Pelvic Infection / Q000209:etiology* / Q000382:microbiology / Q000517:prevention & control*; D011183:Postoperative Complications / Q000209:etiology / Q000382:microbiology / Q000517:prevention & control; D012307:Risk Factors; D013917:Thrombin; D014014:Tissue Adhesives / Q000009:adverse effects*; D014621:Vagina / Q000382:microbiology; D055815:Young Adult
chemical_list: D014014:Tissue Adhesives; D005780:Gelatin; D013917:Thrombin