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

Jpn J Ophthalmol. 2011 Jul;55(4):321-326. doi: 10.1007/s10384-011-0025-3. Epub 2011 May 24.

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.

MeSH terms

  • Aged
  • Anti-Bacterial Agents / therapeutic use
  • Bacteria / isolation & purification*
  • Bacteriological Techniques
  • Conjunctiva / microbiology*
  • Cornea / microbiology*
  • Corneal Transplantation*
  • Disinfection / methods
  • Endophthalmitis / microbiology*
  • Endophthalmitis / prevention & control
  • Eye Banks
  • Eye Infections, Bacterial / microbiology*
  • Eye Infections, Bacterial / prevention & control
  • Female
  • Gentamicins / therapeutic use
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Sclera / microbiology*
  • Time Factors
  • Tissue Donors

Substances

  • Anti-Bacterial Agents
  • Gentamicins