Bakterijske infekcije povezane sa transplantacijom koštanog alografta
Sažetak
Uvod/Cilj. Koštani alograftovi često se koriste u rekonstruktivnim ortopedskim procedurama. U cilju procene prirode i učestalosti kontaminacije koštanih alograftova i pratećih hirurških infekcija, analizirani su podaci koštane banke u našoj instituciji. Metode. Retrospektivno je analiziran mikrobiološki nalaz odbačenih koštanih alograftova i hirurškog mesta primalaca. Prikazana je serija bolesnika sa ispoljenom infekcijom operativnog mesta nakon transplantacije koštanog alografta. Zasejavanje briseva 309 glava butnih kostiju živih donora posle preloma vrata butne kosti ili primarne totalne artroplastike kuka obavljeno je od januara 2007. do decembra 2013. godine. U prevenciji kontaminacije koštanih alograftova korišćeno je 2 mg/mL amikacina prilikom njihovog topljenja. Stopa infekcije analizirana je kod 197 primalaca. Rezultati. Od 309 doniranih femoralnih glava, zbog bakterijske kontaminacije odbačeno je 37, dajući stopu kontaminacije od 11,97%. Postoperativnim praćenjem 213 koštanih alotransplantacija kod 197 primalaca ustanovljena je stopa infekcije od 2,03%. Koagulaza negativni Staphylococcus bio je najčešće identifikovani uzročnik kontaminacije koštanih alograftova i hirurškog mesta primalaca. Zaključak. Stope bakterijske kontaminacije koštanih alograftova i infekcije hirurškog mesta primalaca u našoj ustanovi u skladu su sa međunarodnim standardima. Koagulaza negativni Staphylococcus bio je najčešće identifikovani uzročnik kontaminacije koštanih alograftova i hirurškog mesta primalaca. Nema čvrstih dokaza da su infekcije operativnog mesta bile u vezi sa upotrebom koštanog alografta. Planiramo dalja unapređenja u rukovanju i dekontaminaciji koštanog alografta visokokoncentrovanim rastvorima antibiotika u cilju sniženja rizika od infekcije kod primalaca.
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