Clostridium infections associated with musculoskeletal-tissue allografts
Clostridium infections associated with musculoskeletal-tissue allografts
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DOI：
10.1056/nejmoa023222
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发表时间：
2004-06-17
影响因子：
158.5
通讯作者：
Archibald, LK
中科院分区：
文献类型：
--
作者：
Kainer, MA;Linden, JV;Archibald, LK
背景：同种异体骨移植常用于骨科重建手术。2001年，美国组织银行分发了大约875,000个同种异体肌肉骨骼移植物。在一名23岁的男子死于索氏梭菌败血症后，他从组织库(组织库A)接受了受污染的同种异体移植物，疾病控制和预防中心启动了一项调查，包括加强病例发现，用于组织的恢复、处理和检测的方法。方法：从1998年1月到2002年3月，同种异体移植物相关性梭状芽孢杆菌感染的病例被定义为同种异体移植物植入后一年内手术部位经培养证实的感染。我们追踪了组织，找到了回收和处理这些组织的组织库。结果：14例患者均接受过组织库处理的同种异体移植物，其中接受过组织库A处理的同种异体组织的梭菌感染率为0.12%，尤其是接受股骨柄的患者感染率为0.36%。经组织库A处理的组织与其他组织库相比，梭状芽孢杆菌感染的风险比估计为无穷大(P
Background: Allografts are commonly used in orthopedic reconstructive surgery. In 2001, approximately 875,000 musculoskeletal allografts were distributed by U.S. tissue banks. After the death from Clostridium sordellii sepsis of a 23-year-old man who had received a contaminated allograft from a tissue bank (Tissue Bank A), the Centers for Disease Control and Prevention initiated an investigation, including enhanced case finding, of the methods used for the recovery, processing, and testing of tissue.Methods: A case of allograft-associated clostridium infection was defined as a culture-proven infection of a surgical site within one year after allograft implantation, from January 1998 to March 2002. We traced tissues to tissue banks that recovered and processed these tissues. We also estimated the rates of and risk ratios for clostridium infections for tissues processed by the implicated tissue bank and reviewed processing and testing methods used by various tissue banks.Results: Fourteen patients were identified, all of whom had received allografts processed by Tissue Bank A. The rates of clostridium infection were 0.12 percent among patients who received sports-medicine tissues (i.e., tendons, femoral condyles, menisci) from Tissue Bank A and 0.36 percent among those who received femoral condyles in particular. The risk-ratio estimates for clostridium infections from tissues processed by Tissue Bank A, as compared with those from other tissue banks, were infinite (P