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Detection of Bacteria Colonizing Titanium Spinal Implants in Children
Leonie Wagner1, Lena Braunschweig1, Helmut Eiffert2
11 Pediatric Orthopaedics, Department of Trauma, Orthopaedic and Plastic Surgery, University Medical Center Goettingen , Goettingen, Germany .
Surgical Infections
|December 1, 2017
Summary
Bacterial colonization of VEPTR implants affects 40% of pediatric scoliosis patients. Swab with tissue culture is the most effective detection method, aiding in preventing implant infections.
Area of Science:
- Pediatric Orthopedics
- Spinal Surgery
- Infectious Disease
Background:
- Bacterial colonization of spinal implants, like Vertical Expandable Prosthetic Titanium Rib (VEPTR) devices, can lead to severe complications in early-onset scoliosis.
- Early and accurate detection of microbial formation is critical to prevent delayed infections associated with VEPTR implants.
- Understanding colonization rates and risk factors is essential for improving patient outcomes in pediatric spinal deformity surgery.
Purpose of the Study:
- To determine the prevalence and identify risk factors for bacterial colonization of VEPTR implants in children undergoing spinal lengthening procedures.
- To compare the efficacy of various diagnostic methods for detecting microbial formation on VEPTR implants.
Main Methods:
- Prospective evaluation of 42 children with spinal deformities undergoing 95 VEPTR implant surgeries.
- Utilized multiple detection techniques: implant swabs, tissue culture swabs, removed lock analysis, Polymerase Chain Reaction (PCR), and confocal microscopy.
- Assessed potential risk factors associated with implant colonization.
Main Results:
- Bacterial colonization was detected in 40% (17/42) of patients, with Propionibacterium acnes and coagulase-negative staphylococci being the most frequent isolates.
- Increasing age, body height, and weight were identified as significant risk factors for VEPTR implant colonization.
- Swab with tissue culture demonstrated the highest sensitivity for detection, while direct microscopy and PCR showed lower sensitivity. Standard blood infection markers were inconclusive.
Conclusions:
- While the clinical impact of colonized VEPTR implants requires further elucidation, preventing microbial formation is a key clinical goal.
- Reliable, cost-effective, and user-friendly diagnostic tools are necessary for effective VEPTR implant colonization detection.
- Swab combined with tissue culture shows promise as the preferred diagnostic method for VEPTR implant colonization in pediatric scoliosis patients.
