Skip to main content
Top
Published in: Japanese Journal of Ophthalmology 4/2011

01-07-2011 | Clinical Investigation

Conjunctival swabs and corneoscleral rim cultures from corneal transplantation donors as possible early indicators for posttransplant endopthalmitis

Authors: Makiko Matsumoto, Kiyoshi Suzuma, Noritake Miyamura, Naoki Imamura, Takashi Kitaoka

Published in: Japanese Journal of Ophthalmology | Issue 4/2011

Login to get access

Abstract

Purpose

To determine by microbiological examinations the rate of conjunctiva and corneoscleral rim contamination of cadaver donor tissues.

Methods

A prospective review of culture results for 98 cadaver donor conjunctival swabs [mean age 76.4 ± 12.9 years (±SD)]. Transplant patients were evaluated both before and after disinfection with gentamicin. Individual parameters evaluated included detection rates of bacteria, variety of detected bacteria, time interval from donor death to tissue harvest and age of donors.

Results

Before disinfection, 60 out of 98 conjunctival swabs exhibited microbial growth, while only 36 out of 98 exhibited growth after disinfection (p = 0.0006). Longer intervals between death and tissue harvest were associated with higher positive microbial growth rates. Prior to disinfection, culture-positive donors (74.1 ± 13.6 years) were significantly younger than culture-negative donors (79.8 ± 10.8 years) (p = 0.024). Positive donor rim cultures were noted in 2 out of the 22 corneal transplantations. Microorganisms isolated from the corneal grafts matched those found in the conjunctiva.

Conclusions

It is recommended that the corneoscleral buttons be removed as soon as possible. Cultures of conjunctival swabs collected from donors after disinfection may be useful in determining treatment for postoperative infections occurring after corneal transplantation.
Literature
1.
go back to reference Aaberg TM Jr, Flynn HW Jr, Schiffman J, Newton J. Nosocomial acute-onset postoperative endophthalmitis survey. A 10-year review of incidence and outcomes. Ophthalmology. 1998;105:1004–10.CrossRefPubMed Aaberg TM Jr, Flynn HW Jr, Schiffman J, Newton J. Nosocomial acute-onset postoperative endophthalmitis survey. A 10-year review of incidence and outcomes. Ophthalmology. 1998;105:1004–10.CrossRefPubMed
2.
go back to reference Wu PC, Kuo HK, Li M, Lai IC, Fang PC, Lin SA, Shin SJ, et al. Nosocomial postoperative endophthalmitis: a 14-year review. Graefes Arch Clin Exp Ophthalmol. 2006;244:920–9.CrossRefPubMed Wu PC, Kuo HK, Li M, Lai IC, Fang PC, Lin SA, Shin SJ, et al. Nosocomial postoperative endophthalmitis: a 14-year review. Graefes Arch Clin Exp Ophthalmol. 2006;244:920–9.CrossRefPubMed
3.
go back to reference Taban M, Behrens A, Newcomb RL, Nobe MY, McDonnell PJ. Incidence of acute endophthalmitis following penetrating keratoplasty: a systematic review. Arch Ophthalmol. 2005;123:605–9.CrossRefPubMed Taban M, Behrens A, Newcomb RL, Nobe MY, McDonnell PJ. Incidence of acute endophthalmitis following penetrating keratoplasty: a systematic review. Arch Ophthalmol. 2005;123:605–9.CrossRefPubMed
4.
go back to reference Wilhelmus KR, Hassan SS. The prognostic role of donor corneoscleral rim cultures in corneal transplantation. Ophthalmology. 2007;114:440–5.CrossRefPubMed Wilhelmus KR, Hassan SS. The prognostic role of donor corneoscleral rim cultures in corneal transplantation. Ophthalmology. 2007;114:440–5.CrossRefPubMed
5.
go back to reference Rehany U, Balut G, Lefler E, Rumelt S. The prevalence and risk factors for donor corneal button contamination and its association with ocular infection after transplantation. Cornea. 2004;23:649–54.CrossRefPubMed Rehany U, Balut G, Lefler E, Rumelt S. The prevalence and risk factors for donor corneal button contamination and its association with ocular infection after transplantation. Cornea. 2004;23:649–54.CrossRefPubMed
6.
go back to reference Hassan SS, Wilhelmus KR. Eye-banking risk factors for fungal endophthalmitis compared with bacterial endophthalmitis after corneal transplantation. Am J Ophthalmol. 2005;139:685–90.CrossRefPubMed Hassan SS, Wilhelmus KR. Eye-banking risk factors for fungal endophthalmitis compared with bacterial endophthalmitis after corneal transplantation. Am J Ophthalmol. 2005;139:685–90.CrossRefPubMed
7.
go back to reference Leveille AS, McMullan FD, Cavanagh HD. Endophthalmitis following penetrating keratoplasty. Ophthalmology. 1983;90:38–9.CrossRefPubMed Leveille AS, McMullan FD, Cavanagh HD. Endophthalmitis following penetrating keratoplasty. Ophthalmology. 1983;90:38–9.CrossRefPubMed
8.
go back to reference Antonios SR, Cameron JA, Badr IA, Habash NR, Cotter JB. Contamination of donor cornea: postpenetrating keratoplasty endophthalmitis. Cornea. 1991;10:217–20.CrossRefPubMed Antonios SR, Cameron JA, Badr IA, Habash NR, Cotter JB. Contamination of donor cornea: postpenetrating keratoplasty endophthalmitis. Cornea. 1991;10:217–20.CrossRefPubMed
9.
go back to reference Kloess PM, Stulting RD, Waring GO 3rd, Wilson LA. Bacterial and fungal endophthalmitis after penetrating keratoplasty. Am J Ophthalmol. 1993;115:309–16.CrossRefPubMed Kloess PM, Stulting RD, Waring GO 3rd, Wilson LA. Bacterial and fungal endophthalmitis after penetrating keratoplasty. Am J Ophthalmol. 1993;115:309–16.CrossRefPubMed
10.
go back to reference Wiffen SJ, Weston BC, Maguire LJ, Bourne WM. The value of routine donor corneal rim cultures in penetrating keratoplasty. Arch Ophthalmol. 1997;115:719–24.CrossRefPubMed Wiffen SJ, Weston BC, Maguire LJ, Bourne WM. The value of routine donor corneal rim cultures in penetrating keratoplasty. Arch Ophthalmol. 1997;115:719–24.CrossRefPubMed
11.
go back to reference Hassan SS, Wilhelmus KR, Dahl P, Davis GC, Roberts RT, Ross KW, et al. Infectious disease risk factors of corneal graft donors. Arch Ophthalmol. 2008;126:235–9.CrossRefPubMedPubMedCentral Hassan SS, Wilhelmus KR, Dahl P, Davis GC, Roberts RT, Ross KW, et al. Infectious disease risk factors of corneal graft donors. Arch Ophthalmol. 2008;126:235–9.CrossRefPubMedPubMedCentral
12.
go back to reference Hassan SS, Wilhelmus KR. Quality assessment and microbiologic screening of donor corneas. Cornea. 2007;26:953–5.CrossRefPubMed Hassan SS, Wilhelmus KR. Quality assessment and microbiologic screening of donor corneas. Cornea. 2007;26:953–5.CrossRefPubMed
13.
go back to reference Ritterband DC, Shah MK, Meskin SW, Seedor JA, Koplin RS, Perez W, et al. Efficacy and safety of voriconazole as an additive in Optisol GS: a preservation medium for corneal donor tissue. Cornea. 2007;26:343–7.CrossRefPubMed Ritterband DC, Shah MK, Meskin SW, Seedor JA, Koplin RS, Perez W, et al. Efficacy and safety of voriconazole as an additive in Optisol GS: a preservation medium for corneal donor tissue. Cornea. 2007;26:343–7.CrossRefPubMed
14.
go back to reference Borderie VM, Laroche L. Microbiologic study of organ-cultured donor corneas. Transplantation. 1998;66:120–3.CrossRefPubMed Borderie VM, Laroche L. Microbiologic study of organ-cultured donor corneas. Transplantation. 1998;66:120–3.CrossRefPubMed
15.
go back to reference Albon J, Armstrong M, Tullo AB. Bacterial contamination of human organ-cultured corneas. Cornea. 2001;20:260–3.CrossRefPubMed Albon J, Armstrong M, Tullo AB. Bacterial contamination of human organ-cultured corneas. Cornea. 2001;20:260–3.CrossRefPubMed
16.
go back to reference Fontana L, Errani PG, Zerbinati A, Musacchi Y, Di Pede B, Tassinari G. Frequency of positive donor rim cultures after penetrating keratoplasty using hypothermic and organ-cultured donor corneas. Cornea. 2007;26:552–6.CrossRefPubMed Fontana L, Errani PG, Zerbinati A, Musacchi Y, Di Pede B, Tassinari G. Frequency of positive donor rim cultures after penetrating keratoplasty using hypothermic and organ-cultured donor corneas. Cornea. 2007;26:552–6.CrossRefPubMed
17.
go back to reference Everts RJ, Fowler WC, Chang DH, Reller LB. Corneoscleral rim cultures: lack of utility and implications for clinical decision-making and infection prevention in the care of patients undergoing corneal transplantation. Cornea. 2001;20:586–9.CrossRefPubMed Everts RJ, Fowler WC, Chang DH, Reller LB. Corneoscleral rim cultures: lack of utility and implications for clinical decision-making and infection prevention in the care of patients undergoing corneal transplantation. Cornea. 2001;20:586–9.CrossRefPubMed
18.
19.
go back to reference Mindrup EA, Dubbel PA, Doughman DJ. Betadine decontamination of donor globes. Cornea. 1993;12:324–9.CrossRefPubMed Mindrup EA, Dubbel PA, Doughman DJ. Betadine decontamination of donor globes. Cornea. 1993;12:324–9.CrossRefPubMed
20.
go back to reference Nash RW, Lindquist TD, Kalina RE. An evaluation of saline irrigation and comparison of povidone–iodine and antibiotic in the surface decontamination of donor eyes. Arch Ophthalmol. 1991;109:869–72.CrossRefPubMed Nash RW, Lindquist TD, Kalina RE. An evaluation of saline irrigation and comparison of povidone–iodine and antibiotic in the surface decontamination of donor eyes. Arch Ophthalmol. 1991;109:869–72.CrossRefPubMed
21.
go back to reference Garweg J, Hagenah M, Engelmann K, Bohnke M. Corneoscleral discs excised from enucleated and non-enucleated eyes are equally suitable for transplantation. Acta Ophthalmol Scand. 1997;75:483–6.CrossRefPubMed Garweg J, Hagenah M, Engelmann K, Bohnke M. Corneoscleral discs excised from enucleated and non-enucleated eyes are equally suitable for transplantation. Acta Ophthalmol Scand. 1997;75:483–6.CrossRefPubMed
Metadata
Title
Conjunctival swabs and corneoscleral rim cultures from corneal transplantation donors as possible early indicators for posttransplant endopthalmitis
Authors
Makiko Matsumoto
Kiyoshi Suzuma
Noritake Miyamura
Naoki Imamura
Takashi Kitaoka
Publication date
01-07-2011
Publisher
Springer Japan
Published in
Japanese Journal of Ophthalmology / Issue 4/2011
Print ISSN: 0021-5155
Electronic ISSN: 1613-2246
DOI
https://doi.org/10.1007/s10384-011-0025-3

Other articles of this Issue 4/2011

Japanese Journal of Ophthalmology 4/2011 Go to the issue