BACKGROUND: During December 2000-July 2001, black sediment was noted in saline-filled silicone breast implants of women who had undergone revision surgery at facility A. Curvularia fungus was isolated from implant saline. METHODS: To identify risk factors for contamination with Curvularia species, we performed case-control, retrospective cohort, and laboratory studies and conducted procedural reviews. A case patient was defined as any woman who underwent revision surgery at facility A between January 2000 and June 2001 and had black sediment in her implants. RESULTS: Five patients met the case definition. Contamination was associated with having had surgery performed in operating room (OR) 2 (4/88 vs. 1/140; P=.07) and a longer duration of surgery (P<.001). A longer duration spent in the OR was an additional risk factor (P=.005). Curvularia fungus was isolated from the sterile supply room, where saline bottles had been stored under a water-damaged ceiling, and from the corridor outside OR 2; it was also found more commonly from facility A personnel than from non-facility A personnel (12/34 vs. 4/60; P<.001). Saline was warmed in a cabinet opposite OR 2, which was maintained at negative pressure differentials, then was poured into bowls open to the OR 2 environment before injection into implants. CONCLUSION: Surgeons should always use closed systems to inflate breast implants. Surgery center infection control measures must include moisture control and balanced ventilation systems.
BACKGROUND: During December 2000-July 2001, black sediment was noted in saline-filled silicone breast implants of women who had undergone revision surgery at facility A. Curvularia fungus was isolated from implant saline. METHODS: To identify risk factors for contamination with Curvularia species, we performed case-control, retrospective cohort, and laboratory studies and conducted procedural reviews. A case patient was defined as any woman who underwent revision surgery at facility A between January 2000 and June 2001 and had black sediment in her implants. RESULTS: Five patients met the case definition. Contamination was associated with having had surgery performed in operating room (OR) 2 (4/88 vs. 1/140; P=.07) and a longer duration of surgery (P<.001). A longer duration spent in the OR was an additional risk factor (P=.005). Curvularia fungus was isolated from the sterile supply room, where saline bottles had been stored under a water-damaged ceiling, and from the corridor outside OR 2; it was also found more commonly from facility A personnel than from non-facility A personnel (12/34 vs. 4/60; P<.001). Saline was warmed in a cabinet opposite OR 2, which was maintained at negative pressure differentials, then was poured into bowls open to the OR 2 environment before injection into implants. CONCLUSION: Surgeons should always use closed systems to inflate breast implants. Surgery center infection control measures must include moisture control and balanced ventilation systems.
Authors: Anastasia P Litvintseva; Steven Hurst; Lalitha Gade; Michael A Frace; Remy Hilsabeck; James M Schupp; John D Gillece; Chandler Roe; David Smith; Paul Keim; Shawn R Lockhart; Shankar Changayil; M Ryan Weil; Duncan R MacCannell; Mary E Brandt; David M Engelthaler Journal: J Clin Microbiol Date: 2014-06-20 Impact factor: 5.948
Authors: Laura Elena Carreto-Binaghi; Lisandra Serra Damasceno; Nayla de Souza Pitangui; Ana Marisa Fusco-Almeida; Maria José Soares Mendes-Giannini; Rosely Maria Zancopé-Oliveira; Maria Lucia Taylor Journal: Biomed Res Int Date: 2015-05-27 Impact factor: 3.411
Authors: Shanti Narayanasamy; Adam R Williams; Wiley A Schell; Rebekah W Moehring; Barbara D Alexander; Thuy Le; Ramesh A Bharadwaj; Michelle McGauvran; Jacob N Schroder; John R Perfect Journal: Open Forum Infect Dis Date: 2021-11-03 Impact factor: 3.835