Hospital Clinic de Barcelona, Barcelona, Spain.
Department of Surgery, School of Medicine, University of Barcelona, Barcelona, Spain.
Eye (Lond). 2021 Nov;35(11):3087-3093. doi: 10.1038/s41433-020-01342-8. Epub 2021 Jan 19.
To evaluate microbiological culture rate and positivity of corneoscleral rim and cornea storage media as well as possible risk factors for contamination with real-world data.
Data of consecutive cornea donors implanted in the reference centre from January 2013 to January 2018 were reviewed. Information about cornea characteristics (donor demographic data, endothelial cell density, type of cornea conservation, days of storage, and precut vs full-thickness tissue), and microbiological culture information (corneoscleral rim vs storage sample, positive result) were statistically analysed.
During the study period, 1369 corneas (737 donors) were implanted. Cultures were performed in 76.8% (n = 1052) of them and were positive in 3.2% of cases, mainly bacteria (84.4%). Corneas preserved in hypothermia represented 61.8% of all positive microbiology results (p < 0.001). Other analysed risk factors did not reach statistically significant association with microbiological positivity. None of the 34 cases with positive microbiological cultures reported ocular infection for the recipients in at least 6 months' follow-up.
Microbiological tests rate in real-world practice are high despite not being compulsory. Organotypic cultured corneas showed a statistically less positivity in corneoscleral and storage medium than hypothermic ones, resulting in another advantage of this kind of cornea storage. Although precut corneas are thought to present less microbiological positivity, a statistically significant association was not found in the present study.
利用真实世界的数据评估角膜缘和角膜储存介质的微生物培养率和阳性率,以及可能的污染风险因素。
回顾 2013 年 1 月至 2018 年 1 月期间在参考中心植入的连续供体角膜的数据。统计分析了有关角膜特征(供体人口统计学数据、内皮细胞密度、角膜保存类型、储存天数、预切割与全厚组织)和微生物培养信息(角膜缘与储存样本、阳性结果)的信息。
在研究期间,共植入了 1369 枚角膜(737 名供体)。对其中 76.8%(n=1052)的角膜进行了培养,有 3.2%的病例培养结果为阳性,主要为细菌(84.4%)。低温保存的角膜占所有阳性微生物学结果的 61.8%(p<0.001)。其他分析的风险因素与微生物学阳性率均无统计学显著关联。在至少 6 个月的随访中,未发现 34 例微生物学培养阳性的受者出现眼部感染。
尽管并非强制性要求,但在实际操作中,微生物学检测率仍然很高。器官培养的角膜在角膜缘和储存介质中的阳性率明显低于低温保存的角膜,这是这种角膜储存方式的另一个优势。尽管预切割角膜被认为具有较低的微生物阳性率,但在本研究中未发现统计学显著关联。