Tran Devin, Dhaliwal Deepinder, Kamyar Roheena, Jhanji Vishal, Kowalski Regis P
Department of Ophthalmology, University of Pittsburgh School of Medicine, University of Pittsburgh Medical Center (UPMC), Pittsburgh, PA.
Cornea. 2019 Jul;38(7):901-904. doi: 10.1097/ICO.0000000000001969.
Fungal infections in lamellar keratoplasty are a growing concern. Optisol-GS does not contain an antifungal agent and supplementation with 0.255 μg/mL Amphotericin B (AmpB) has been considered. This study tested the ability of 0.255 μg/mL AmpB in Optisol-GS to eliminate yeast contamination of corneal tissue.
Three isolates of Candida albicans, 1 of Candida parapsilosis, and 1 of Candida glabrata were tested in Optisol with and without AmpB. Corneoscleral rims stored at -80°C were thawed and placed in 10 multiwell plates (4 per plate). The rims were inoculated with 4 respective loads of yeast: 0, 10, 10, and 10 colony-forming units in 2 sets of 5 for 5 yeasts. One set was filled with Optisol plus AmpB and the other with Optisol only. All 10 plates were incubated at cold storage (2°C-8°C) for 48 hours. After 48 hours, all corneal rims were placed into 10 mL of yeast extract peptone dextrose medium; a swab culture of each well was plated onto Sabouraud plates; and all plates with the remaining Optisol were incubated at 30°C. Yeast growth was monitored for 10 days. Minimum inhibitory concentration and minimum fungicidal concentration were determined.
All corneoscleral specimens were positive regardless of fungal load or presence of AmpB. All controls remained negative. Minimum inhibitory concentrations and minimum fungicidal concentrations were equivalent and ranged between 0.5 and 2.0 μg/mL.
AmpB at a concentration of 0.255 μg/mL in Optisol-GS at cold storage (2°C-8°C) over 48 hours did not eliminate yeast from corneal tissue.
板层角膜移植术中真菌感染问题日益受到关注。Optisol-GS不含抗真菌剂,有人考虑添加0.255μg/mL两性霉素B(AmpB)。本研究测试了Optisol-GS中0.255μg/mL AmpB消除角膜组织酵母污染的能力。
对白色念珠菌的3个分离株、近平滑念珠菌的1个分离株和光滑念珠菌的1个分离株在含和不含AmpB的Optisol中进行测试。将储存在-80°C的角膜缘解冻并放入10个多孔板中(每个板4个)。向角膜缘接种4种不同的酵母载量:5种酵母各2组,每组5个,载量分别为0、10、10和10个菌落形成单位。一组用Optisol加AmpB填充,另一组仅用Optisol填充。所有10个板在冷藏(2°C-8°C)下孵育48小时。48小时后,将所有角膜缘放入10mL酵母提取物蛋白胨葡萄糖培养基中;每个孔的拭子培养物接种到沙氏平板上;所有剩余Optisol的平板在30°C下孵育。监测酵母生长10天。测定最低抑菌浓度和最低杀菌浓度。
无论真菌载量或AmpB的存在如何,所有角膜缘标本均为阳性。所有对照均为阴性。最低抑菌浓度和最低杀菌浓度相当,范围在0.5至2.0μg/mL之间。
在冷藏(2°C-8°C)48小时的Optisol-GS中,浓度为0.255μg/mL的AmpB未能消除角膜组织中的酵母。