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   Table of Contents      
ARTICLE
Year : 1987  |  Volume : 35  |  Issue : 4  |  Page : 194-196

Microbial contaminants of donor eyes and their antimicrobial sensitivity patterns


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Date of Web Publication20-Dec-2008

Correspondence Address:
V M Mahajan
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Source of Support: None, Conflict of Interest: None


PMID: 3333649

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  Abstract 

Culturing of 1493 donor eyes yielded positive growth in 172 eyes A total of 181 different organisms were recovered, 77.4% of which were Gram negative, 20.9% Gram positive cocci and the remaining were two strains of Candida albicans and one of Nocardia asteroides. Pseudomonas aeruginose was the largest isolate followed by Staphylococcus aureus, Alkaligenes faecalis and Acinetobacter calcoaceticus. The highest sensitivity of Pseudomonas was to polymyxin B, followed by gentamicin. The maximum number of isolates of S. aureus were sensitive to cloxacillin followed by chloramphenicol and gentamicin. The over all sensitivity of all types of organisms was the highest to gentamicin. Streptomycin was the least effective. Pre-treatment of donor material with these antibiotics is suggested.


How to cite this article:
Mahajan V M, Angra S K. Microbial contaminants of donor eyes and their antimicrobial sensitivity patterns. Indian J Ophthalmol 1987;35:194-6

How to cite this URL:
Mahajan V M, Angra S K. Microbial contaminants of donor eyes and their antimicrobial sensitivity patterns. Indian J Ophthalmol [serial online] 1987 [cited 2019 Jun 17];35:194-6. Available from: http://www.ijo.in/text.asp?1987/35/4/194/26186


  Introduction Top


With the increasing incidence of keratoplasty, the study of the behaviour of conjunctival flora after death in particular, is becoming exceedingly important [1] . Though cases of endophthalmitis, corneal ulcers and graft infection following pene­trating keratoplasty have been reported [2],[3],[4],[5],[6] ,only few have actually documented donor corneal contamination as a source of these complications; yet the determination of microbial flora of cadaver eyes, their antimicrobial sensitivity patterns and their elimination before transplantation to the recepients is obligatory in eye bank practice. The flora have essentially been reported to be the same in both cadaveric and living eyes However, a few organisms, notably Gram negative bacilli, are more frequently seen in cadaver eyes [1],[7],[8],[9],[10] .The present study reports microbial flora and their antibiograms with a view to recommend suitable antimicrobial agents with which the donor cornea can be pretreated before transplanting to the recipient to avoid the risk of postoperative infec­tions leading to rejection of the tissue.


  Material and Methods Top


One hundred and seventy eight bacterial isolates were obtained from 172 eyes (11.5%) out of a total of 1493 donor eyes collected over a period from 1978-1984. The method of collection of the material and its processing in the microbiology laboratory for identification of the micro­organisms and their sensitivity patterns was the same as described earlier by Mahajan [11] .


  Observations Top


A total of 172 eyes yielded 181 strains (12.1 %) of different micro-organisms The sensitivity patterns of 178 were studied; the remaining three being two isolates (1.1%) of Candida albicans and one of Nocardia asteroides [Table 1]. Mixed growth of bacteria were obtained trom eight eyes, the details of which are as follows:

Staphylococcus aureus + Acinetobacter calcoaceticus = 2 eyes

Staphylococcus aureus + Pseudomonas aeruginosa = 3 eyes

Staphylococcus aureus + Pseudomonas aeruginosa + Escherichia coli = 1 eye

Pseudomonas aeruginosa + Acinetobacter calcoaceticus = 1 eyes

Pseudomonas aeruginosa + Alkaligenes faecalis = 1 eye


  Discussion Top


The contamination rate seems to be considerably low when compared to those reported by others [1] .The year wise distribution of the main pathogens is shown in [Table 2].

It seems that the main pathogens have remained the same over the years though percentages have differed Study of their antimicrobial sensitivity becomes therefore all the more important The test was done against streptomycin (15 ug), tetracycline (30 ug), chloramphenicol (10 ug), erythromycin (15 ug), framycetin (30 ug), genta­micin (10 ug), cloxacillin (1 ug), and polymyxin B (100 units) by the disc diffusion technique, and the results were interpreted as recommended by Bauer et a1 [12] . Erythromycin and cloxacillin were tested only for staphylococci and polymyxin B for Pseudomonas Only six strains viz two each of Alkaligenes and Acinetobacter and one each of Esch cofi and Pseudomonas were resistant to all the antibiotics tested. Eighty six percent strains of Pseudomonas were sensitive to polymyxin B and the least (3.5%) were to streptomycin This is the largest isolate (32.0%) obtained in our series. In the eye-banks where eyes are not treated with polymyxin and are instead treated with strepto­penicillin, infection is likely to ensue post-opera­tively, consequently jeopardising the graft Where the pre-treatment is done with gentamicin, which has been found effective against 45.6% of the strains obtained in our series, better results than those yielded by streptopenicillin are certain. Incidentally, the over - all sensitivity has been the maximum to gentamicin which took care of 53.9% of the total isolates If may therefore be selected for blanket treatment of the cadaver eyes Some have recommended irrigation of the cornea and conjunctiva of cadaver eyes with a stream of sterile saline prior to enucleation, coupled with the use of gentamicin, polymyxin B neomycin and gramicidin solution, thus rendering the buttons safe for use [7],[8] .

Chloramphenicol has been found to be the second best as 46.1% of the total isolates were found sensitive to it The highest sensitivity of S. aureus, Alkaligenes and Acinetobacter has also been to this antibiotic. One may prefer to use chloramphenicol for pre-treatment of cadaver eyes and gentamicin may be kept as an ideal and effective antibiotic for the postoperative period.

It is recommended that pre-treatment of donor corneas with gentamicin, chloramphenicol and polymyxin B be carried out successively to render the buttons safe for transplantation.

 
  References Top

1.
Kanski, J.J. Br. J. Ophthalmol49 : 445, 1965  Back to cited text no. 1
    
2.
Le Francois, M; and Baum, J.L Arch OphthalmoL 94: 1907, 1976.  Back to cited text no. 2
    
3.
Larson, P.A; Undostrom, RL and Doughman, D.J. Arch. Ophthalmo. 96:1019,1978.  Back to cited text no. 3
    
4.
Khodadoust, AA and Franklin, RM Am. J. Ophthalmol. 87: 130, 1979.  Back to cited text no. 4
    
5.
Escapini, FL; Olson, RJ. and Kaufman, FL E Am J. Ophthalmol. 88: 59, 1979.  Back to cited text no. 5
    
6.
Mahajan, V .M Ann OphthalmoL 16:147, 1984.  Back to cited text no. 6
    
7.
Pardos, G.JJ and Gallagher, MA Arch Ophthalmol. 100: 1611, 1982.  Back to cited text no. 7
    
8.
Polack, F.M; Locatcher-Khorazo, 0 and Gutierrez E Arch. Ophthalmol. 78: 219, 1967.  Back to cited text no. 8
    
9.
Boerg-Ans, J.; Badsberg, E and Rasmussen, J. Br. J. Ophthalmol 46: 365, 1962.  Back to cited text no. 9
    
10.
Sudama Ind. J. Ophthalmol 22:17,1983.  Back to cited text no. 10
    
11.
Mahajan, V .M Br. J. Ophthalmol 67: 191. 1983.  Back to cited text no. 11
    
12.
Bauer, AW.; Kirby, W.MM; Sherri-, J.C and Turck, M Am J. Clin PathoL 45: 493, 1966.  Back to cited text no. 12
    



 
 
    Tables

  [Table 1], [Table 2]



 

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Abstract
Introduction
Material and Methods
Observations
Discussion
References
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