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沙特阿拉伯一家三级医院感染供体角膜组织移植的发生率及结果

Incidence and Outcomes of Transplant of Infected Donor Corneal Tissues in a Tertiary Hospital in Saudi Arabia.

作者信息

Almulhim Ammar, Alnaim Abdullah F, Abdulrazek Ahmed, Alotaibi Hammam A

机构信息

Ophthalmology, Al-Jabr Eye and ENT Hospital, Al-Ahsa, SAU.

Ophthalmology, Dhahran Eye Specialist Hospital, Dhahran, SAU.

出版信息

Cureus. 2022 May 31;14(5):e25514. doi: 10.7759/cureus.25514. eCollection 2022 May.

Abstract

PURPOSE

The aim of this study is to assess donor rim culture results and predict ocular infections after corneal transplantation to determine the relationship between positive corneoscleral rim cultures and post-keratoplasty infection.

DESIGN

This is a retrospective study.

METHODS

The microbiology results of positive donor rim culture and clinical outcomes of all contaminated grafts at Dhahran Eye Specialist Hospital (DESH) in the Eastern Region of Saudi Arabia between October 2016 and February 2020 were reviewed.

RESULTS

A total of 684 corneal transplantation procedures were performed at DESH during this period. Routine donor rim cultures were done for all cases with six positive cases (0.88%). There were five positive fungal donor rim cultures (0.73%), and one corneal rim was positive for both bacterial and fungal cultures (0.15%). Among these six patients, two patients (33.33%) who received graft positive with candida developed an infection. Both cases required further interventions but were unsuccessful and eventually ended up with re-grafting.

CONCLUSION

In the sample collected, positive fungal contamination was more frequent than bacterial contamination, and the incidence of bacterial infection is relatively low compared to that of fungal infection due to contaminated grafts. Despite the limitations of our study, we support routine corneoscleral rim culture and to start prophylactic antifungal treatment in response to positive donor fungal rim culture.

摘要

目的

本研究旨在评估供体角膜缘培养结果,并预测角膜移植术后眼部感染情况,以确定角膜巩膜缘培养阳性与角膜移植术后感染之间的关系。

设计

这是一项回顾性研究。

方法

回顾了2016年10月至2020年2月期间沙特阿拉伯东部地区达兰眼科专科医院(DESH)所有污染移植物的供体角膜缘培养阳性的微生物学结果及临床结局。

结果

在此期间,DESH共进行了684例角膜移植手术。所有病例均进行了常规供体角膜缘培养,其中6例阳性(0.88%)。真菌供体角膜缘培养阳性5例(0.73%),1例角膜缘细菌和真菌培养均阳性(0.15%)。在这6例患者中,2例(33.33%)接受念珠菌阳性移植物的患者发生了感染。两例均需进一步干预,但未成功,最终均进行了再次移植。

结论

在采集的样本中,真菌污染阳性比细菌污染更常见,与因移植物污染导致的真菌感染相比,细菌感染的发生率相对较低。尽管本研究存在局限性,但我们支持常规进行角膜巩膜缘培养,并针对供体真菌角膜缘培养阳性开始预防性抗真菌治疗。

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