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Rare infection found in two knee surgery patients after receiving allograft tissue
The CDC urges physicians to report any implanted tissue covered under the recent MTF recall.
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Two knee surgery patients have become infected after receiving soft tissue allograft from the Musculoskeletal Transplant Foundation, according to the Centers for Disease Control and Prevention.
After the first case in September, the Musculoskeletal Transplant Foundation (MTF), of Edison, N.J., voluntarily recalled all tissue processed in its Jessup, Pa., facility over a 6-month period prior to the reported infection, according to MTF spokesperson Cindy Gordon. The incidents are the first in MTF's 20-year history.
Gordon told Orthopedics Today that the Centers for Disease Control and Prevention (CDC), the FDA and MTF agree that the distributed tissue poses a minimal infection risk. The FDA and CDC have both publicly stated that these incidents are unrelated to other problems with tissue banks reported over the past year.
In September, the Minnesota Department of Health reported the first case of Chryseobacterium meningosepticum — a rare pathogen in human infections — linked to MTF, said Arjun Srinivasan, MD, a CDC medical epidemiologist.
Srinivasan told Orthopedics Today that MTF reported the second case earlier this month after learning about it from a California physician. MTF said it learned of the second infection in November.
"Both patients were treated with antibiotics and are doing well; both grafts remain implanted. In both cases the tissue came from the Jessup facility, but the tissue came from separate donors," MTF wrote in an e-mailed statement to Orthopedics Today.
In April, MTF noticed an increase in the number of donated tissue that failed sterility tests at the Jessup facility, Gordon said. MTF rejected all tissues that failed the tests and did not distribute them.
MTF determined that the Jessup facility distributed 4,700 pieces of soft tissue from February 2006 to September 2006. Through the MTF Tissue Trace System, the company found that 2,300 tissues were implanted and 2,400 were recovered under the recall, according to the MTF statement.
In the first case, the CDC gathered sufficient evidence through molecular testing and DNA fingerprinting to confirm the tissue that caused the infection, and will perform the same tests on the second patient.
"We haven't heard about any more cases, but we continue to work very closely with [MTF] to see if there are other ways we should be looking for more cases," Srinivasan told Orthopedics Today.
Srinivasan said some hospitals might still be investigating whether clinicians used the recalled tissue. He urged physicians to determine whether any of their patients might have had similar infections by asking their microbiology labs to see if Chryseobacterium meningosepticum had been recovered from any cultures of post-orthopedic surgery infections.
For the future, he said physicians should strive to consistently return the implant cards that are included with each tissue allograft so that companies can correspond directly with the physician to alert them of a recall.
For more information:
- Arjun Srinivasan, MD, medical epidemiologist, Centers for Disease Control and Prevention, 1600 Clifton Road NE, MS-A35, Atlanta, GA 30333, 404 639-3311, beu8@cdc.gov.
- Cindy Gordon, for MTF, Issues Management/Insight Communication, 101 Poor Farm Road, Princeton, NJ 08540, 609 252-1300, cgordon@issuesllc.com.