|Year : 1987 | Volume
| Issue : 4 | Page : 194-196
Microbial contaminants of donor eyes and their antimicrobial sensitivity patterns
VM Mahajan, SK Angra
|Date of Web Publication||20-Dec-2008|
V M Mahajan
Source of Support: None, Conflict of Interest: None
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 2020 Apr 7];35:194-6. Available from: http://www.ijo.in/text.asp?1987/35/4/194/26186
| Introduction|| |
With the increasing incidence of keratoplasty, the study of the behaviour of conjunctival flora after death in particular, is becoming exceedingly important  . Though cases of endophthalmitis, corneal ulcers and graft infection following penetrating keratoplasty have been reported ,,,, ,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 ,,,, .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|| |
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  .
| Observations|| |
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|| |
The contamination rate seems to be considerably low when compared to those reported by others  .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  . 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 , .
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.
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[Table 1], [Table 2]