Erbezci M, Monnot P H, Michel-Briand Y, Masse M, Delbosc B
Clinique d'Ophtalmologie, CHU Jean Minjoz, Besançon.
J Fr Ophtalmol. 1995;18(2):106-13.
In order to reduce the risk of infection, we analyzed each stage of conservation of human cornea in organ culture at +31 degrees C.
This epidomiological study was conducted in 266 human corneas preserved in organ culture between January 1991 and December 1993. There were 3 stages: In the period of preservation (analysis of the contaminated medium), Before clinical use of the graft (analysis of the preservation medium), After the penetrating keratoplasty (analysis of the corneo-scleral rim and the transportation medium). The bacteriological media used were thioglycolate broth, trypticase soja and Sabouraud.
In 266 storage media, 42 (15.7%) cultures are positive. The most commonly found organism was Staphylococcus aureus (21.4%). At the end of the conservation procedure, all of the cultures of the media were sterile (n = 165). After penetrating keratoplasty, 8 cultures were positive for the transportation medium and the corneo-scleral rim (5.1%), 3 cultures were positive for the corneo-scleral rim only (1.9%) and 5 cultures were positive (3.2%) for the transportation medium without contamination of the corneo-scleral rim.
Preservation at +31 degrees C in organ culture of human corneas allows elimination of the contaminated or potentially contaminant corneas before an eventual transplantation. In our experience, the risk of infection is especially situated in the period of preservation which shows the insuffiency of the decontamination procedures or the antibiotical content of the medium and probably the virulence of the organisms in donors hospitalized for long period.
为降低感染风险,我们分析了人角膜在31摄氏度器官培养保存的各个阶段。
这项流行病学研究对1991年1月至1993年12月间保存在器官培养中的266个人角膜进行。有3个阶段:保存期(分析污染的培养基)、移植临床使用前(分析保存培养基)、穿透性角膜移植术后(分析角膜巩膜缘和运输培养基)。使用的细菌学培养基有硫乙醇酸盐肉汤、胰蛋白酶大豆肉汤和沙氏培养基。
在266份储存培养基中,42份(15.7%)培养物呈阳性。最常见的微生物是金黄色葡萄球菌(21.4%)。在保存程序结束时,所有培养基培养物均无菌(n = 165)。穿透性角膜移植术后,运输培养基和角膜巩膜缘有8份培养物呈阳性(5.1%),仅角膜巩膜缘有3份培养物呈阳性(1.9%),运输培养基有5份培养物呈阳性(3.2%),角膜巩膜缘未受污染。
人角膜在31摄氏度器官培养保存可在最终移植前排除受污染或潜在受污染的角膜。根据我们的经验,感染风险尤其存在于保存期,这表明去污程序或培养基抗生素含量不足,可能还有长期住院供体中微生物的毒力问题。