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中期保存的供体角膜中的微生物污染

Microbiological contamination in donor corneas preserved for medium-term.

作者信息

Li Gui-Gang, Zhu Hui, Ji Cai-Ni, Zang Xin-Jie

机构信息

Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei Province, China.

Department of Ophthalmology, Third Hospital of Wuhan, Wuhan, 430060, Hubei Province, China.

出版信息

Cell Tissue Bank. 2019 Sep;20(3):379-387. doi: 10.1007/s10561-019-09776-5. Epub 2019 Jun 25.

DOI:10.1007/s10561-019-09776-5
PMID:31240495
Abstract

To evaluate the characteristics of microbiological contamination in donor corneas preserved for medium-term. A total of 82 donated corneas from June 1, 2014 to November 30, 2014 were retrospectively analyzed. The corneas were preserved in cornea chambers medium-term solution at 4-8 °C for keratoplasty. After removal of the central corneas for transplantation, the corneoscleral rims were put back into the medium for 1 month at room temperature (20-25 °C). The suspicious contaminated storage solutions indicated with transparency or color change were examined with bacteria and fungi cultivation for strain identification. The data collected included gender, age, procurement site and causes of death of donors, and follow-up of recipients. Statistical analysis was performed using Microsoft Excel and SPSS 24.0. Significance level was set at a P value < 0.05. The overall pathogen positive rate was 9.8% (n = 8), including 7 (87.5%) fungi and 1 (12.5%) bacteria. They were 2 (2.44%) Fusarium, 2 (2.44%) Chromomycosis, 1 (1.22%) Candida albicans, 1 (1.22%) Aspergillus versicolor, 1 (1.22%) Acremonium species, and 1 (1.22%) Enterococcus. 5 contaminated corneas were used for penetrating keratoplasty; although four out of five (80%) had not been given antifungal drugs during more than 6 months following-up period, none of the recipients was infected with a graft. Donor age (P = 0.839), gender (P = 0.062), procurement sites (P = 0.713) and cause of death (P = 0.711) had no statistically significant influence on the contamination rate. All donor corneas have a possibility of microbiological contamination. Strict tissue preservation protocol but not antifungal drugs following keratoplasty seems necessary to prevent graft infection.

摘要

评估中期保存的供体角膜微生物污染特征。回顾性分析2014年6月1日至2014年11月30日期间共82例捐献的角膜。角膜在角膜保存盒中于4 - 8°C的中期保存液中保存用于角膜移植。在取出中央角膜用于移植后,将角膜缘放回保存液中在室温(20 - 25°C)下保存1个月。对出现透明度或颜色变化的可疑污染保存液进行细菌和真菌培养以鉴定菌株。收集的数据包括供体的性别、年龄、获取部位和死因,以及受体的随访情况。使用Microsoft Excel和SPSS 24.0进行统计分析。显著性水平设定为P值<0.05。总体病原体阳性率为9.8%(n = 8),其中7例(87.5%)为真菌,1例(12.5%)为细菌。分别为2例(2.44%)镰刀菌、2例(2.44%)着色真菌、1例(1.22%)白色念珠菌、1例(1.22%)杂色曲霉、1例(1.22%)枝顶孢属和1例(1.22%)肠球菌。5例污染角膜用于穿透性角膜移植;尽管在超过6个月的随访期内五分之四(80%)未给予抗真菌药物,但无一例受体发生移植感染。供体年龄(P = 0.839)、性别(P = 0.062)、获取部位(P = 0.713)和死因(P = 0.711)对污染率无统计学显著影响。所有供体角膜都有可能发生微生物污染。严格的组织保存方案而非角膜移植后的抗真菌药物似乎对预防移植感染是必要的。

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