Pre-banking microbial contamination of donor conjunctiva and storage medium for penetrating keratoplasty
The aims of this study were to investigate the incidence of positive donor tissue cultures before transfer to preservation medium (Optisol™-GS) for penetrating keratoplasty, to verify the efficacy of antibiotics contained in Optisol™-GS by examining the drug susceptibility and to assess the relationship between the results of our microbial assessments as well as donor factors and the incidence of contamination.
We conducted a retrospective, cross-sectional study using Juntendo Eye Bank records for all corneal transplantations. Two hundred donor conjunctiva harvestings and storage medium (EP-II®) cultures were performed between July 2008 and June 2011. We analyzed the associations between donor factors (age, gender, history of cataract surgery, death-to-preservation interval, cause of death) and contamination rates using multivariate analysis by the generalized estimating equation model.
We obtained positive bacterial cultures from 154 of the 200 eyes (77.0%). The isolated bacteria were indigenous, such as coagulase-negative Staphylococci, Corynebacterium sp., and methicillin-resistant Staphylococcus aureus (MRSA). There was significant resistance to levofloxacin (18 eyes, 9.0%) and gentamicin (12 eyes, 6.0%), and no vancomycin-resistant bacteria were detected. The donor factors did not correlate with the prevalence of bacterial contamination in our criteria.
Pre-banking microbial assessment allows for microbial detection, bacterial susceptibility and resistance testing. This is useful for developing preservation mediums containing effective spectrum antibiotic agents for high quality control of corneal banking.
KeywordsEye banking Bacterial contamination Donor conjunctiva Corneoscleral rim Preservation medium
We thank Juntendo Eye Bank, Japan Organ Transplant Network and Oyama Lions Club for their cornea donations. The authors thank Dr. Alireza Mashaghi, Dr. Jiaxu Hong and Dr. Masahiro Nakamura for critically reading and editing the manuscript, Dr. Ayako Nakamura for her microbiological insight and Peter Mallen for his assistance in creating the elegant figure.
Conflicts of interest
All authors declared that they have no conflict of interest.
- 5.Constantinou M, Jhanji V, Vajpayee RB. Clinical and microbiological profile of post-penetrating keratoplasty infectious keratitis in failed and clear grafts. Am J Ophthalmol. 2013;155(233–7):e2.Google Scholar
- 25.Eye Bank Association of America. Medical Standards 2016 2014 [Available from: http://restoresight.org/wp-content/uploads/2016/10/Med-Standards-October-2016.pdf.
- 26.Institute CaLS. Performance standards for antimicrobial susceptibility testing, 26th informational supplement M100-S26 2016 [Available from: http://em100.edaptivedocs.info/GetDoc.aspx?doc=CLSIM100S26:2016&scope=user.
- 32.Murali S, Jambulingam M, Tiru V, Kulanthai LT, Rajagopal R, Padmanaban P, et al. A study on isolation rate and prevalence of drug resistance among microorganisms isolated from multiorgan donor and donor corneal rim along with a report on existence of bla NDM-1 among Indian population. Curr Eye Res. 2012;37:195–203.CrossRefPubMedGoogle Scholar