Department of Ophthalmology, J.Minjoz University Hospital, Besançon, France.
Clinical Methodology Center, University Hospital, Besançon, France.
Cornea. 2021 Jun 1;40(6):696-703. doi: 10.1097/ICO.0000000000002618.
This study aimed to assess how the contamination rate of organ-cultured corneas has evolved and to analyze the evolution of microorganisms involved.
Data from the Besançon eye bank were reviewed over 14 years (2005-2018). The changes in the contamination rate and the contaminant species found during the organ culture storage were analyzed. Microbiological tests were performed twice on the storage media-at day 5 and before the deswelling phase.
Among the 17,979 donor corneas collected, 1240 corneas were microbiological-test positive. The average annual contamination rate was 6.8% (range: 5.2%-8.9%). Seventy-five percent of contaminations were bacterial. The most frequently found bacterium was Staphylococcus spp. (31.3%), followed by non-Enterobacteriaceae Gram-negative Bacilli (GNB) (27.3%), with most Sphingomonas spp. and Pseudomonas spp. Fungal contamination (21.9%) was dominated by Candida (82.7%). Seventy-seven types of microorganisms were identified. The Staphylococcus rate tended to decrease, whereas non-Enterobacteriaceae GNB rate has increased in the past few years to reach 46% of bacteria. Most of the contaminations were detected in the early phase of organ culture at day 5 (89.2%). The second microbiological test found 44.8% of fungal contaminations (predominantly Candida spp.).
The annual contamination rate was stable and remains low, but the types of contaminating microorganisms varied from year to year. Staphylococcus spp. and non-Enterobacteriaceae GNB accounted for a significant proportion of the contaminations. We found a significant proportion of contamination, especially fungal, at the late phase of storage. Reassessing the antibiotics and antifungals in the storage medium may be useful to limit corneal disposal.
本研究旨在评估器官培养角膜的污染率是如何演变的，并分析相关微生物的演变情况。
回顾了贝桑松眼库 14 年来（2005-2018 年）的数据。分析了器官培养储存过程中污染率和污染物种的变化。在储存介质中进行了两次微生物检测-在第 5 天和肿胀前阶段。
在收集的 17979 个供体角膜中，有 1240 个角膜微生物检测呈阳性。平均年污染率为 6.8%（范围：5.2%-8.9%）。75%的污染是细菌。最常见的细菌是葡萄球菌属（31.3%），其次是非肠杆菌科革兰氏阴性杆菌（GNB）（27.3%），主要是鞘氨醇单胞菌属和假单胞菌属。真菌感染（21.9%）以念珠菌为主（82.7%）。共鉴定出 77 种微生物。葡萄球菌的比率呈下降趋势，而非肠杆菌科 GNB 的比率近年来有所增加，达到细菌的 46%。大多数污染发生在器官培养的早期阶段（第 5 天）（89.2%）。第二次微生物检测发现 44.8%的真菌污染（主要是念珠菌属）。
年污染率保持稳定且较低，但污染微生物的种类逐年变化。葡萄球菌属和非肠杆菌科 GNB 是主要的污染菌。我们发现储存后期存在大量污染，特别是真菌污染。重新评估储存介质中的抗生素和抗真菌药物可能有助于限制角膜的处理。
