fungal contamination of saline-filled breast implants

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Silicone breast implants may be contaminated-study

Fri Jul 15, 2005 5:30 PM BST

By Will Boggs, MD

http://today.reuters.co.uk/news/newsArticle.aspx?

type=healthNews & storyID=2005-07-

15T163028Z_01_B588775_RTRIDST_0_HEALTH-SILICONE-CONTAMINATED-DC.XML

NEW YORK (Reuters Health) - Five cases of fungal contamination of

saline-filled breast implants were likely caused by poor infection

control measures during the implant procedures and in the operating

room, according to a report.

According to investigators, black sediment was seen in the implants

of five women who had undergone a second surgery to correct various

problems they were having with their breast implants.

A fast-growing fungus found in soil called Curvularia fungus was

isolated from the saline in the removed implants, Dr. n A.

Kainer, from the Tennessee Department of Health in Nashville, and

colleagues report in The Journal of Infectious Diseases.

One surgeon operating in a freestanding same-day surgery center

performed all five procedures. Many of these centers do not have

infection control experts on staff to ensure that infection control

guidelines are being followed, Kainer told Reuters Health.

Careful investigation of the surgical center revealed a number of

problems that could have contributed to the contaminated implants

including negative pressure in the operating room relative to the

outside room as well as warm conditions supporting the growth and

spread of the fungus. The surgeon also filled the implant with

saline using an open-bowl technique -- a no-no.

" This outbreak, " the investigators say, " provides scientific

evidence to support the recommendation that operating rooms should

be at positive pressure relative to the surrounding areas and that a

closed system should be used when injecting sterile saline

into...breast implants. "

" Surgery center infection control measures, " the team adds, " must

include moisture control and balanced ventilation systems. "

SOURCE: Journal of Infectious Diseases July 1, 2005.