The influence of donor factors on corneal organ culture contamination
Anja K Gruenert1, Katja Rosenbaum2, Gerd Geerling2
1Department of Ophthalmology, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany.
Purpose:
To evaluate the contamination rate and the corresponding spectrum of microbes and to identify donor risk factors for corneal organ culture contaminations.
Methods:
A total of 3306 organ-cultured donor corneas were included in the study. We performed a retrospective database analysis to evaluate donor factors such as gender, age, death-to-explantation interval (DEI), procurement site and cause of death and to determine their influence on donor cornea contaminations. Odds ratios (ORs) were calculated for each factor.
Results:
The overall contamination rate was 7.8% (n = 259). Younger donor age (OR: 2.2, p = 0.003, chi-squared test), a DEI of more than 24 hr (OR: 1.6, p < 0.001), hospitalization prior to death (OR: 2.2, p < 0.001) and death caused by sepsis (OR: 2.7, p < 0.001) were associated with an increased risk of contamination, whereas donor gender did not have an effect on donor cornea contaminations. The most frequently isolated microbes were Enterococci (19%), Staphylococci (10.8%) and Candida (37.4%).
Conclusion:
This study helps to estimate the contamination risk of a cultured cornea based on specific donor factors. However, donors with risk factors should not be generally excluded from cornea donation. Further studies including antibiograms might clarify whether a change in the antibiotic composition of the culture medium would be useful to deal with the increasing number of multi-resistant microbes.
Insights
Younger donor age, longer death-explantation intervals, prior hospitalization, and sepsis-related death increase corneal graft contamination risk. However, these factors do not warrant general exclusion from cornea donation programs.
Area of Science:
- Ophthalmology
- Microbiology
- Transplantation Science
Background:
- Corneal transplantation is a common procedure to restore vision.
- Organ culture is a standard method for preserving donor corneas.
- Understanding contamination sources is crucial for successful transplantation outcomes.
Purpose of the Study:
- To determine the contamination rate in organ-cultured donor corneas.
- To identify the spectrum of microbial contaminants.
- To identify donor-specific risk factors associated with corneal organ culture contamination.
Main Methods:
- Retrospective analysis of 3306 organ-cultured donor corneas.
- Evaluation of donor factors: age, gender, death-to-explantation interval (DEI), procurement site, and cause of death.
- Calculation of odds ratios (ORs) to assess the influence of each factor on contamination.
Main Results:
- Overall contamination rate was 7.8%.
- Increased contamination risk associated with younger donor age (OR: 2.2), DEI > 24 hours (OR: 1.6), prior hospitalization (OR: 2.2), and sepsis as cause of death (OR: 2.7).
- Most common microbes: Candida (37.4%), Enterococci (19%), and Staphylococci (10.8%). Donor gender had no significant effect.
Conclusions:
- Donor factors can help estimate contamination risk in corneal organ cultures.
- Risk factors identified should not lead to automatic exclusion of potential donors.
- Further research on antibiograms and culture medium composition is needed to address multi-resistant microbes.
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