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Contamination of corneal tissue from infected donors
Abstract:
Thirty-two corneas with scleral rims were cultured from the eyes of 17 cadavers that harbored systemic infection at the time of death. Twelve (71%) of 17 cadavers demonstrated corneal contamination from one or both corneas. Eleven (92%) of 12 donors with positive postmortem blood cultures had positive corneal cultures from at least one eye. Six of these 12 had the same organism isolated from both the blood and corneal tissue. Bacterial corneal cultures were negative in the five donors with negative postmortem blood cultures. Control cultures were obtained from 19 eyes of ten donors without evidence of infection at death. Four (21%) of 19 control eyes yielded Staphylococcus epidermidis. There was a significantly higher incidence of corneal contamination in donors who died with systemic infections. Eye banks should continue to screen donors carefully for documented or suspected sepsis in an effort to reduce the incidence of postkeratoplasty infections.
Insights
Systemic infections in deceased donors significantly increase corneal contamination risk. Careful donor screening by eye banks is crucial to prevent postkeratoplasty infections, especially from sepsis.
Area of Science:
- Ophthalmology
- Microbiology
- Transplantation
Background:
- Corneal contamination can lead to postkeratoplasty infections.
- Systemic infections at the time of death may increase the risk of corneal contamination in donors.
Purpose of the Study:
- To investigate the incidence of corneal contamination in cadaveric donors with systemic infections.
- To determine the correlation between systemic infection and microbial growth in donor corneas.
Main Methods:
- Corneal and scleral rim cultures were performed on 32 corneas from 17 donors with systemic infections.
- Blood cultures were analyzed for donors with systemic infections.
- Control cultures were obtained from 19 corneas of 10 donors without evidence of infection.
Main Results:
- Twelve of 17 (71%) donors with systemic infections had contaminated corneas.
- Eleven of 12 donors with positive blood cultures had positive corneal cultures.
- Six donors had the same organism isolated from both blood and cornea; bacterial cultures were negative in donors without systemic infection.
Conclusions:
- Donors with systemic infections have a significantly higher incidence of corneal contamination.
- Eye banks must rigorously screen donors for sepsis to minimize postkeratoplasty infection risk.