Sawa Bruna, Ribeiro Victoria Stadler Tasca, Kraft Letícia, Wollmann Luciana Cristina, Pegoraro Danielle, Suss Paula Hansen, Tuon Felipe Francisco
Division of Infectious Diseases, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, PR, Brazil.
Human Tissues Bank, Pontifícia Universidade Católica do Paraná, Curitiba, PR, Brazil.
Cell Tissue Bank. 2019 Mar;20(1):87-94. doi: 10.1007/s10561-019-09754-x. Epub 2019 Feb 6.
The contamination of the transport solution used in cardiovascular allografts can occur from different sources. Risk factors associated with positive microbiological test of transport solution have not been reported previously. This study aimed to determine the risk factor for contamination of transport solution used in the heart valve allografts stored in a Brazilian tissue bank. This retrospective study was conducted on all donors of cardiovascular allografts stored in a tissue bank from December 2008 to December 2017. Microbiological cultures for aerobic and anaerobic bacteria, fungi/yeasts were carried out in TS. Clinical variables were included. From 1001 transport solution, 52% were contaminated. A total of 770 microorganisms were identified, and Staphylococcus spp. was identified in 248 isolates (32.2%). Skin bacteria from skin microbiota were the most commonly identified microorganisms (Staphylococcus spp., Cutibacterium spp., Corynebacterium spp., and Bacillus spp.), occurring in 49.6%. The presence of a diagnosis of healthcare-associated infection was not associated with skin contamination (odds ratio [OR] 0.62 [0.41-0.94]; p = 0.014). Conditions like fever, use of antibiotics, and leukocytosis were less likely associated with contamination of transport solution. A longer warm ischemic time was associated with higher frequency of contamination. In the multivariable analysis, warm ischemic time was independently associated with contamination, and antibiotic therapy was a factor that decreased the rate of contamination (p < 0.05). Contamination of transport solution is associated with modifiable risk factors, such as warm ischemic time. Measures to minimize contamination should be employed to avoid unnecessary tissue discharges.
心血管同种异体移植物中使用的运输溶液可能来自不同来源的污染。运输溶液微生物检测呈阳性相关的风险因素此前尚未见报道。本研究旨在确定巴西一家组织库中储存的心脏瓣膜同种异体移植物运输溶液污染的风险因素。这项回顾性研究对2008年12月至2017年12月期间储存在一家组织库中的所有心血管同种异体移植物供体进行。在运输溶液中进行需氧菌、厌氧菌、真菌/酵母菌的微生物培养。纳入临床变量。在1001份运输溶液中，52%受到污染。共鉴定出770种微生物，其中葡萄球菌属在248株分离菌中被鉴定出来（32.2%）。皮肤微生物群中的皮肤细菌是最常鉴定出的微生物（葡萄球菌属、丙酸杆菌属、棒状杆菌属和芽孢杆菌属），占49.6%。医疗保健相关感染的诊断与皮肤污染无关（优势比[OR]为0.62[0.41 - 0.94]；p = 0.014）。发热、使用抗生素和白细胞增多等情况与运输溶液污染的相关性较小。较长的热缺血时间与较高的污染频率相关。在多变量分析中，热缺血时间与污染独立相关，抗生素治疗是降低污染率的一个因素（p < 0.05）。运输溶液的污染与可改变的风险因素相关，如热缺血时间。应采取措施尽量减少污染，以避免不必要的组织废弃。
