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Published on: June 5, 2017
Microorganism detection and contamination rate of donor eyes in Japan
Yulia Aziza1,2, Hideki Fukuoka3, Tsutomu Inatomi1,4
1Department of Ophthalmology, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Hirokoji-agaru, Kawaramachi-dori, Kamigyo-ku, Kyoto, 602-0841, Japan.
Purpose:
To evaluate the microorganism detection and contamination rate of donor eyes.
Study Design:
Retrospective study.
Methods:
In this retrospective study, we reviewed all donor cornea data collected from Kyoto Prefectural University of Medicine (KPUM) Eye Bank, Kyoto, Japan from April 2015 to June 2018, including microbiologic data obtained from conjunctival swabs and preservation medium and findings of postoperative infection from the medical records.
Results:
During the study period, 77 eyes from 44 deceased individuals (mean age at time of death: 75 ± 17.3 years [range, 30-102 years]) were donated to the KPUM Eye Bank after being harvested using standard safety precautions and disinfection procedures. In 49 of the 77 eyes (63.6%), the conjunctival-swab culture revealed microorganisms, with the 3 most commonly detected being methicillin-resistant Staphylococcus epidermidis (MRSE), methicillin-sensitive S aureus (MSSA), and methicillin-resistant S aureus (MRSA). The data revealed positive microorganism detection in only 4 (5.2%) of the 77 donor-cornea storage-medium cultures. Positive microorganism detection was found in all the age groups, with no statistical difference between the groups (P > .05). In the eyes enucleated ≥ 2.5 h postmortem, a higher positive microorganism detection occurred (P = .03). During the postoperative follow-up period, there was no record of corneal infection.
Conclusions:
The preenucleation conjunctival-swab-culture findings revealed that the rate of positive microorganism detection was similar for advanced-age and younger-age donors and that a shorter elapsed time from donor death to postmortem enucleation resulted in less donor-microorganism contamination.
Insights
Microorganism detection in donor eyes was common via conjunctival swabs, but contamination of donor corneas was rare. Shorter postmortem enucleation time reduced donor-microorganism contamination, with no reported postoperative infections.
Area of Science:
- Ophthalmology
- Microbiology
- Transplantation Science
Background:
- Donor eye quality is crucial for successful corneal transplantation.
- Microbial contamination of donor corneas can lead to severe postoperative complications.
Purpose of the Study:
- To assess the prevalence of microorganism detection in donor eyes using conjunctival swabs.
- To determine the contamination rate of donor corneas.
- To identify factors influencing microorganism detection in donor eyes.
Main Methods:
- Retrospective analysis of donor cornea data from Kyoto Prefectural University of Medicine (KPUM) Eye Bank (April 2015 - June 2018).
- Review of microbiologic data from conjunctival swabs and preservation medium.
- Examination of postoperative infection records.
Main Results:
- Microorganisms were detected in 63.6% of conjunctival swabs, with methicillin-resistant Staphylococcus epidermidis (MRSE) being most common.
- Only 5.2% of donor-cornea storage medium cultures showed positive microorganism detection.
- Higher microorganism detection rates were observed in eyes enucleated ≥2.5 hours postmortem (P=.03).
- No corneal infections were reported during postoperative follow-up.
Conclusions:
- Conjunctival swabs frequently detect microorganisms in donor eyes, irrespective of donor age.
- Minimizing the time between donor death and eye enucleation reduces donor-microorganism contamination.
- The low rate of corneal medium contamination suggests effective preservation and handling procedures.
