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Graefe's Archive for Clinical and Experimental Ophthalmology
Published in: Graefe's Archive for Clinical and Experimental Ophthalmology 10/2020

01-10-2020 | Gentamicin | Cornea

Intensive care unit time and prolonged enucleation to processing interval are associated with donor cornea contamination

Authors: Isabella Funfas Bandeira Medina, Ana Paula Miyagusko Taba Oguido, Mariana Ragassi Urbano, Antônio Marcelo Barbante Casella

Published in: Graefe's Archive for Clinical and Experimental Ophthalmology | Issue 10/2020

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Abstract

Purpose

To determine donor cornea contamination rate and to determine factors associated with cornea contamination. To assess the effect of hospitalization, intensive care unit (ICU) time, and antibiotic use on corneal contamination rate. To determine the spectrum of the contaminating microorganisms.

Methods

The contamination rate of 212 corneas, obtained by enucleation from April 2014 to January 2015 in a single eye bank, was assessed retrospectively according to age, sex, cause of death, systemic antibiotic use, hospitalization time, ICU time, mechanical ventilation (MV), death to enucleation interval (DEI), enucleation to processing interval (EPI), and corneal epithelial exposure grading. The relative risk (RR) and adjusted RR with a 95% confidence interval were calculated using IBM-SPSS 20.0.

Results

The contamination rate was 35.6% (n = 75). On multivariate analysis, ICU stay of 4 days or longer and enucleation to processing interval (EPI) greater than 7.4 h (RR 1.58, CI 0.96–2.60, P = 0.06) were associated with donor cornea contamination. Corneal contamination risk was highest from 4 to 6 days at the ICU (RR 3.40, CI 1.54–7.51, P < 0.01) and decreased after 7 days (RR 2.22, CI 1.00–4.93, P = 0.05). Coagulase-negative Staphylococcus was the most common isolated bacteria (69.6%). The frequency of gentamicin-resistant bacteria was higher among patients who stayed 4 days or longer at the ICU.

Conclusion

Patients staying at the intensive care unit 4 days or longer showed increased risk of corneal contamination. This is an important result to consider further indication for cornea donation.
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Metadata
Title
Intensive care unit time and prolonged enucleation to processing interval are associated with donor cornea contamination
Authors
Isabella Funfas Bandeira Medina
Ana Paula Miyagusko Taba Oguido
Mariana Ragassi Urbano
Antônio Marcelo Barbante Casella
Publication date
01-10-2020
Publisher
Springer Berlin Heidelberg
Published in
Graefe's Archive for Clinical and Experimental Ophthalmology / Issue 10/2020
Print ISSN: 0721-832X
Electronic ISSN: 1435-702X
DOI
https://doi.org/10.1007/s00417-020-04758-w

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