2008-2009 University Scholar Profile

Stephanie Stopka

Mentors: MaryBeth Horodyski and Lennox Archibald
College of Medicine

"I applied to the University Scholars program in hopes that it would facilitate my learning and experience in research. I worked with one of my mentors the previous summer assisting with a multitude of various research projects, but I never got to experience one from start to finish or have the opportunity to take full control over one project. The scholars program is allowing me to conquer both of these crucial skills, which will further my capabilities of continuing research as a physician. Also, learning how to balance research, school, life, and fun right now will help make the balancing of research, practicing medicine, life, and fun much easier down the road."

Courses of Study
Major

Food Science and Human Nutrition

Research Interests

Medicine with an emphasis in nutrition, sports medicine, and surgery.

Awards
Volunteer Service / Organizations
Athletic Achievement
Hobbies/Activities

Sewing, knitting, building things with her hands, playing soccer or training, triathlons, volleyball, weight lifting, kayaking.

Research Description
Utility of Pre-implantation Gram Stain and Culturing of Allograft Tissues Used in Orthopaedic Surgical Procedures

At present, a substantial number of orthopaedic surgeons across the United States obtain gram stains and microbiological cultures of allograft tissues just prior to surgical implantation. Not surprisingly, skin or environmental microorganisms, such as coagulase-negative staphylococcus or Bacillus species, are often isolated. Gram stains are usually within hours culture results are usually available several days after the surgical procedure. Either way, a positive gram stain or culture outcome invariably results in the surgeon initiating antimicrobial therapy, even if the patient is asymptomatic in the post-operative period. The net result is inappropriate prescribing of antimicrobials. In some quarters, the practice has extended to obtaining cultures of metal hardware just before implantation in some orthopaedic procedures. To date, there is no published data to suggest that pre-implantation gram stains or cultures actually improve patient outcomes or prevent healthca! re-associated infections.

We will be determining the results of gram stains and cultures of allograft tissue prior to surgical implantation in patients undergoing orthopaedic procedures, and how these results can assist the surgeon in the decision to commence with antimicrobial therapy. For each study participant, 2 swabs of the allograft tissue will be obtained in the operating theatre, using an aseptic technique, before surgeon manipulation and just before implantation. Additionally, a swab will be taking of the incision site at the start of the procedure and one at closure. The swabs will be processed in the microbiology laboratory as follows: (a) cultured on solid media (b) gram stain. In addition, a short standardized questionnaire will be completed for each patient. Recorded data will include patient demographics, any underlying illnesses (e.g., diabetes, renal, or liver disease), type of surgical procedure, type of allograft tissue used, method of allograft processing (i.e., sterilized or aseptically processed), patient outcome, and whether or not an antimicrobial is prescribed following the culture results.

The results of this research project will help ascertain the utility of pre-implantation gram stain and cultures. We believe that pre-implantation cultures of allograft tissues result in unnecessary antimicrobial prescribing. The results of this study are relevant to any endeavor aimed at lowering medical costs, antimicrobial use, and antimicrobial resistance.

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Journal of Undergraduate Research
Volume 10, Issue 3
Spring 2009
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