Microbiological spectrum and risk of transmission of infection from donor tissues of enucleated eyes harvested from septicaemic patients

Abstract

Purpose : To evaluate the microbiological spectrum of corneas from septicaemic donors and whether these corneas can be utilised for corneal transplantation. Study tested the hypothesis that cornea being an avascular tissue carries minimum risk of transmission of systemic infection from donor to recipient

Methods : In this prospective study , corneas donated to the eye bank of a tertiary eye care centre of Central India over a period of 2 years were included. During the corneal retrieval procedure based on the reports of blood culture, septicaemic donors were defined as those whose blood culture tested positive. Donor corneas were allocated to either group I (septicaemic donors) or group II (non-septicaemic donors) based on blood culture reports and death certificate summary. Donor tissue in group I was subjected to a culture of the corneal tissue, scleral rim, aqueous and vitreous samples after retrieval, while in group II was subjected within 72 hours of retrieval. A microbial work-up flow chart was prepared and used for the sterility check of all the donor tissues.Variables were analysed using Fisher’s exact test for probability and statistical significance

Results : A total of 264 corneas from 136 donors were analysed, 42 corneas of which were from septicaemic donors. The microbial growth rates of the corneal tissue from group I and group II donors were close (7.142% vs 9.010%, p=0.30). Most common isolated organism was gram positive cocci.Only one corneal tissue showed similar bacterial growth as those from the blood culture. The rest of the contaminated corneas did not grow the same bacterial strains as those from their blood cultures. Results of the culture analysis of scleral (9.52% in Group I vs 10.81% in Group II), aqueous (4.76% in Group I and 2.25% in Group II), and vitreous (2.38% in Group I vs 1.35% in Group II) samples were statistically insignificant between both the groups

Conclusions : The study showed that corneas from septicaemic donors have equally low infection rates as compared to non-septicaemic donors hence can be utilised for corneal transplantation.

This is a 2021 ARVO Annual Meeting abstract.

 

Figure Caption – Correlation between tissue types of study group exhibiting growth on culture media .