Contaminated rabbit patellar tendon grafts. In vivo analysis of disinfecting methods

Am J Sports Med. 1994 May-Jun;22(3):387-91. doi: 10.1177/036354659402200315.

Abstract

In Part 1 of our study, 40 central-third bone-patellar tendon-bone grafts were harvested from 20 adult California White rabbits under strict sterile conditions. Ten grafts were placed directly into a thioglycolate broth, incubated, and subcultured; no growth was noted in any specimen. The next 6 grafts were contaminated 20 seconds each with 2 different species of coagulase-negative staphylococci. Organisms were grown with cultures obtained from an operating room floor during anterior cruciate ligament reconstruction. Marked growth of both species was noted in all 6 grafts within 24 hours. A subsequent 3 series of 8 grafts each were harvested sterilely, contaminated as described above, and soaked in 1 of 3 solutions 30 minutes before culture. Both 10% povidone-iodine and a triple-antibiotic solution (gentamicin, clindamycin, polymyxin) were 100% ineffective as both organisms grew; 4% chlorhexidine gluconate effectively decontaminated 8 grafts in all cases. Part 2 involved contamination of harvested grafts with 5 common, virulent organisms: Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae, and Enterococcus faecalis. Elimination of all except Klebsiella pneumoniae was successful with 4% chlorhexidine gluconate alone for 8 grafts. Using a triple-antibiotic solution after chlorhexidine gluconate in 6 grafts eliminated this organism also.

MeSH terms

  • Animals
  • Chlorhexidine / analogs & derivatives
  • Chlorhexidine / therapeutic use
  • Clindamycin / administration & dosage
  • Clindamycin / therapeutic use
  • Disinfectants / therapeutic use*
  • Disinfection*
  • Drug Combinations
  • Enterococcus faecalis
  • Escherichia coli Infections / prevention & control
  • Female
  • Gentamicins / administration & dosage
  • Gentamicins / therapeutic use
  • Gram-Positive Bacterial Infections / prevention & control
  • Intraoperative Complications / prevention & control*
  • Klebsiella Infections / prevention & control
  • Klebsiella pneumoniae
  • Male
  • Patellar Ligament / microbiology*
  • Patellar Ligament / transplantation*
  • Polymyxins / administration & dosage
  • Polymyxins / therapeutic use
  • Povidone-Iodine / therapeutic use
  • Pseudomonas Infections / prevention & control
  • Pseudomonas aeruginosa
  • Rabbits
  • Staphylococcal Infections / prevention & control
  • Surgical Wound Infection / microbiology
  • Surgical Wound Infection / prevention & control*

Substances

  • Disinfectants
  • Drug Combinations
  • Gentamicins
  • Polymyxins
  • Clindamycin
  • Povidone-Iodine
  • chlorhexidine gluconate
  • Chlorhexidine