Tuberculosis Outbreak Linked to Bone Grafts Raises Concerns Over Tissue Screening

UK: Recent outbreaks of tuberculosis tied to bone grafts in 2021 and 2023 emphasize the necessity for enhanced screening of donated tissues, according to a Morbidity and Mortality Weekly Report (MMWR) by the Centers for Disease Control and Prevention (CDC).

Common Threads in Outbreaks

The 2021 outbreak affected 113 individuals during spinal surgeries, exposing them to Mycobacterium tuberculosis through the bone-repair product FiberCel. The 2023 outbreak mirrored the previous incident, involving a similar Elutia bone-repair product linked to one tissue donor.

The CDC initiated an investigation in July 2023 after two patients exposed to the bone-repair product during spinal surgeries died of tuberculosis. The contaminated product, manufactured by Elutia, underwent a voluntary recall. The investigation revealed 36 patients had undergone procedures with the product.

Screening Challenges and Recommendations

Elutia had used nucleic acid amplification tests to screen for M. tuberculosis before the 2023 outbreak. However, the MMWR emphasized the need for more sensitive culture-based tests in safety testing. The report suggested including tests that may take up to eight weeks for results.

Both outbreaks involved donors without documented tuberculosis diagnoses but who developed sepsis, linked to the infection. The MMWR proposed combing donor medical records for signs of possible tuberculosis infection and recommending ineligible status for donors with evidence of sepsis.

While the risk of contracting tuberculosis from a bone graft is low, the growing tissue transplant industry demands improved safety measures. The MMWR emphasized the importance of closing safety gaps as tissue allografts have extended expiration dates, allowing ample time for comprehensive testing and donor record scrutiny.

Read the report: Second Nationwide Tuberculosis Outbreak Caused by Bone Allografts Containing Live Cells