Department of Epidemiology and Biostatistics, Research Centre for Emerging and Re-emerging Infectious Diseases, Pasteur Institute of Iran, Tehran, Iran; National Reference Laboratory for Plague, Tularemia and Q Fever, Research Centre for Emerging and Re-emerging Infectious Diseases, Pasteur Institute of Iran, Akanlu, Kabudar Ahang, Hamadan, Iran.
Department of Community Medicine, Tehran University of Medical Sciences, Tehran, Iran.
J Hosp Infect. 2022 May;123:156-173. doi: 10.1016/j.jhin.2021.10.020. Epub 2021 Nov 6.
Bone allografts are harvested and transplanted under sterile conditions. However, the risk of bacterial contamination of grafts during these processes is a health concern. Bioburden testing and bacterial contamination detection are conducted to ensure allograft sterility. The present study aimed to determine the incidence of bacterial contamination in bone allografts based on different classifications. A PROSPERO registration number was received for the study. Systematic searches were conducted in PubMed and EMBASE databases with relevant keywords from January 2000 to March 2021. After choosing related studies according to the PRISMA flow diagram, Stata software was used for data analysis. We considered I˃50% as heterogeneity between studies. The overall incidence of bacterial contamination was 12.6% (95% confidence interval 0.100, 0.152) among 19,805 bone allografts of 17 studies. The bacterial contamination rate among bone allografts was 10.8% before 2010 and 14.7% from January 2010 to March 2021. The contamination frequency in Asia, Europe, and Australia was 11.5%, 14.3% and 5.2%, respectively. Bone contamination rates were higher in cadaver donors (19.9%), retrieval time sampling (13.5%), and swab samples (13.2%) compared with those in living donors (7.5%), implantation time sampling (6.9%), and bone fragments cultures (6.3%). Bacterial contamination was recovered 24.4%, 19.7%, 13.2%, and 21% from tibia, fibula, femoral, and other bones, respectively. Staphylococcus spp. was the predominant isolated bacteria from bones (63.2% of all isolated genera), followed by Propionibacterium spp. (10.6%). In conclusion, the high contamination of bone allografts is a health concern, indicating the need for more health monitoring and improvement of standards.
同种异体骨在无菌条件下采集和移植。然而，在这些过程中，移植物的细菌污染风险是一个健康问题。进行生物负荷测试和细菌污染检测以确保移植物的无菌性。本研究旨在根据不同分类确定同种异体骨的细菌污染发生率。本研究已获得 PROSPERO 注册号。系统检索了 2000 年 1 月至 2021 年 3 月期间 PubMed 和 EMBASE 数据库中与关键词相关的文献，根据 PRISMA 流程图选择相关研究后，使用 Stata 软件进行数据分析。我们认为研究之间的 I˃50%为异质性。17 项研究中的 19805 个同种异体骨中，细菌污染的总发生率为 12.6%（95%置信区间 0.100，0.152）。2010 年之前同种异体骨的细菌污染率为 10.8%，2010 年 1 月至 2021 年 3 月为 14.7%。亚洲、欧洲和澳大利亚的污染频率分别为 11.5%、14.3%和 5.2%。与活体供体（7.5%）、植入时间取样（6.9%）和骨碎片培养（6.3%）相比，尸体供体（19.9%）、回收时间取样（13.5%）和拭子样本（13.2%）的骨污染率更高。从胫骨、腓骨、股骨和其他骨骼中分别回收了 24.4%、19.7%、13.2%和 21%的细菌污染。从骨骼中分离出的主要细菌为葡萄球菌属（所有分离属的 63.2%），其次为丙酸杆菌属（10.6%）。总之，同种异体骨的高污染是一个健康问题，表明需要加强卫生监测和提高标准。
