The influence of donor factors on corneal organ culture contamination

Acta Ophthalmol. 2017 Nov;95(7):733-740. doi: 10.1111/aos.13402. Epub 2017 Mar 7.

Abstract

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.

Keywords: corneal donor; corneal organ culture; culture medium contamination; eye banking.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Bacteria / isolation & purification*
  • Cell Count
  • Cornea / microbiology*
  • Corneal Transplantation*
  • Culture Media / adverse effects*
  • Eye Banks / statistics & numerical data*
  • Eye Infections, Bacterial / microbiology
  • Eye Infections, Fungal / microbiology
  • Female
  • Fungi / isolation & purification*
  • Humans
  • Male
  • Middle Aged
  • Organ Culture Techniques / methods*
  • Organ Preservation / methods
  • Retrospective Studies
  • Risk Factors
  • Tissue Donors / statistics & numerical data
  • Tissue and Organ Procurement
  • Young Adult

Substances

  • Culture Media