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Plaster-associated Bacillus cereus wound infection. A case report
Orthopedics
|April 1, 1986
Summary
Bacillus cereus (B. cereus) caused pin site infections in open forearm fractures. Tap water used to wet plaster-impregnated gauze likely contaminated the materials, leading to infection.
Area of Science:
- Microbiology
- Infectious Diseases
- Orthopedic Surgery
Background:
- Plaster of Paris and nonsterile cast padding are known risk factors for wound infections.
- Open forearm fractures require fixation, often involving Steinmann pins and plaster casts.
Observation:
- Three cases of pin site infections with Bacillus cereus (B. cereus) were observed following open forearm fracture fixation.
- An epidemiological investigation was initiated to identify the source of B. cereus contamination.
Findings:
- B. cereus was isolated from plaster-impregnated gauze rolls (14%) and tap water samples (81%).
- The isolated B. cereus strains shared similar antibiograms and biotypes with those from pin sites.
- Bacillus sp. contamination rates were 58% (dry), 25% (sterile water), and 40% (tap water) for plaster.
Implications:
- Tap water used for wetting plaster-impregnated gauze is a likely source of B. cereus infection.
- Steinmann pins may act as conduits, directing bacteria from the plaster to the pin insertion site.
- Consideration of gas-sterilized plaster materials is recommended in specific clinical scenarios to prevent infection.