Related Experiment Videos
Plaster-associated Bacillus cereus wound infection. A case report
Abstract:
Plaster of Paris and nonsterile cast padding have previously been implicated in wound infections. The observation of three pin site infections with Bacillus cereus following pin placement and plaster fixation of an open forearm fracture led to an epidemiologic investigation. Two hundred sixty-one bacterial cultures were taken from materials in the Steinmann pin application and plaster fixation procedures. B. cereus with a similar antibiogram and biotype as was identified in the pin site cultures was recovered from three of the 22 (14%) plaster-impregnated gauze rolls and six of seven (81%) tapwater samples. The Bacillus sp contamination rate of plaster when dry or wetted with sterile water or tapwater was 58%, 25% and 40% respectively. All cultures of plaster samples were negative after steam or gas sterilization. These results suggest that the patient may have acquired the infection from the plaster-impregnated gauze wetted in tapwater. In this case, the Steinmann pins may have facilitated infection by guiding the plaster-associated bacteria to the pin insertion site. The use of gas sterilized plaster materials should be considered in certain circumstances.
Insights
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.