Farrell P L, Fan J T, Smith R E, Trousdale M D
Doheny Eye Institute, Los Angeles, California.
Cornea. 1991 Sep;10(5):381-6. doi: 10.1097/00003226-199109000-00004.
The incidence of culture-positive cornea rims from 446 consecutive donor corneas cultured at the Doheny Eye Institute between 1986 and 1988 was determined. Both the identity and antibiotic sensitivities of the contaminating organisms were reviewed. Sixty-three (14.1%) of 446 cornea rims were culture-positive, but none of the 63 patients who received these contaminated donor corneas developed endophthalmitis. Streptococcus (26 of 63), Propionibacterium (15 of 63), Stphylococcus (14 of 63) species and diptheroids (8 of 63) were the most common cornea rim contaminants, and in most cases were resistant to gentamicin (i.e., 21 of 26 or 81%, 9 of 15 or 60%, 10 of 14 or 71%, 4 of 8 or 50%, respectively). Virtually all of the gentamicin-resistant bacteria isolated from cornea rims were found to be sensitive to vancomycin. Eye banks should consider the addition of other antibiotics to storage media to reduce donor cornea contamination. Surgeons performing corneal transplantation should also consider these results when selecting antibiotics for use at the time of surgery and in the postoperative period.
测定了1986年至1988年间在多希尼眼科研究所对446个连续供体角膜边缘进行培养的培养阳性率。对污染微生物的种类及抗生素敏感性进行了回顾性分析。446个角膜边缘中有63个(14.1%)培养阳性,但接受这些污染供体角膜的63例患者均未发生眼内炎。链球菌(63例中的26例)、丙酸杆菌(63例中的15例)、葡萄球菌(63例中的14例)和类白喉杆菌(63例中的8例)是最常见的角膜边缘污染物,且在大多数情况下对庆大霉素耐药(即分别为26例中的21例或81%、15例中的9例或60%、14例中的10例或71%、8例中的4例或50%)。从角膜边缘分离出的几乎所有耐庆大霉素细菌对万古霉素敏感。眼库应考虑在保存介质中添加其他抗生素以减少供体角膜污染。进行角膜移植的外科医生在选择手术时及术后使用的抗生素时也应考虑这些结果。