Microbial Contamination in Deceased Musculoskeletal Tissue Donors: A Large-Scale US Analysis of Infection Risk

Area of Science:

• Microbiology
• Transplantation Science
• Public Health

Background:

• Microbial contamination of musculoskeletal tissues from deceased donors presents a significant risk for donor-derived infections and potential tissue exclusion.
• Despite strict aseptic techniques, contamination during recovery and processing remains a persistent challenge in tissue banking.
• This study addresses the critical need for understanding microbial prevalence in deceased tissue donors.

Purpose of the Study:

• To conduct a large-scale analysis of microbial prevalence and distribution in deceased tissue donors across the United States.
• To identify specific microorganisms and assess their potential disqualification for transplantation based on established standards.
• To investigate the anatomical variability of microbial contamination in tissue recovery sites.

Main Methods:

• A retrospective analysis of 1,186,392 musculoskeletal tissue recovery swabs from 69,920 deceased donors (2019-2024) was performed.
• Growth-positive cultures were identified using MALDI-TOF mass spectrometry and biochemical assays.
• Microbial findings were stratified by anatomical recovery zone and assessed against American Association of Tissue Banks (AATB) standards for disqualifying organisms.

Main Results:

• Microbial growth was detected in 12.4% of swabs, with 64.8% of donors exhibiting at least one positive sample.
• Bacteria were the predominant organisms (92.4%), followed by fungi (5.0%) and mixed growth (2.6%).
• Potentially disqualifying organisms, notably Clostridium species and Streptococcus pyogenes, were found in 5.0% of donors, with higher prevalence in lower extremity and pelvic sites.

Conclusions:

• A significant proportion of deceased tissue donors harbor potentially virulent microorganisms, underscoring infection risks in transplantation.
• Substantial anatomical variation in contamination risk necessitates targeted microbiological surveillance strategies.
• Reinforces the critical importance of stringent microbiological screening protocols to ensure the safety of tissue transplantation and minimize recipient infections.