Shahzad I Mian1, Anthony J Aldave2, Elmer Y Tu3, Brandon D Ayres4, Bennie H Jeng5, Marian S Macsai6, Michael L Nordlund7, Jeffrey G Penta8, Sudeep Pramanik9, Loretta B Szczotka-Flynn10, Allison R Ayala11, Wendi Liang11, Maureen G Maguire12, Jonathan H Lass10. 1. Kellogg Eye Center, University of Michigan, Ann Arbor, MI. 2. Stein Eye Institute, University of California, Los Angeles, Los Angeles, CA. 3. Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL. 4. Ophthalmic Partners of PA, Bala Cynwyd, PA. 5. University of California, San Francisco, San Francisco, CA. Dr. Jeng now with the University of Maryland, Baltimore, MD. 6. Northshore University Health System, Glenview, IL. 7. Cincinnati Eye Institute, Cincinnati, OH. 8. San Diego Eye Bank, San Diego, CA. 9. Mid Atlantic Cornea Consultants, Baltimore, MD. 10. Department of Ophthalmology and Visual Sciences, Case Western Reserve University, University Hospitals Eye Institute, Cleveland, OH. 11. Jaeb Center for Health Research, Tampa, FL. 12. Department of Ophthalmology, University of Pennsylvania, Philadelphia, PA.
Abstract
PURPOSE: To assess donor rim culture results and outcomes of ocular infections in the Cornea Preservation Time Study (CPTS). METHODS: Donor corneal rim cultures were optional. Donor characteristics were assessed for association with positive cultures using the Fisher exact test and Poisson regression analyses. Incidence rates of ocular infections were estimated, and 95% confidence intervals were calculated. RESULTS: Cultures were performed in 784 (58.9%) of the 1330 cases. For the 0 to 7-day versus 8 to 14-day preservation time groups, respectively, positive fungal growth occurred in 10 of 397 (2.5%) versus 5 of 387 (1.3%) corneas (P = 0.30), whereas positive bacterial cultures occurred in 6 of 397 (1.5%) versus 4 of 387 (1.0%) corneas (P = 0.75). Surgeon-prepared tissue remained a significant risk for positive fungal cultures [relative risk (RR) of surgeon- versus eye-bank-prepared, 2.85; 95% CI (1.02-7.98)], whereas younger donors [RR per year of age, 0.96; 95% CI (0.93-1.00)] and accidental death donors [RR of accident versus disease, 3.71; 95% CI (1.36-10.13)] were at a greater risk for positive bacterial cultures. Fungal infection (Candida glabrata) developed in 1 (6.7%) of 15 recipients with a positive fungal culture, and no recipient infections occurred with positive bacterial culture. With one additional fungal keratitis (Candida albicans) and one bacterial endophthalmitis (E. coli) with no rim culture performed, a total of 2 of 1330 eyes (0.15%) developed fungal and 1/1330 eyes (0.08%) developed bacterial postkeratoplasty infections. CONCLUSIONS: A longer preservation time was not associated with a higher rate of positive donor rim cultures. The overall rate of infection across the entire cohort was low.
PURPOSE: To assess donor rim culture results and outcomes of ocular infections in the Cornea Preservation Time Study (CPTS). METHODS:Donor corneal rim cultures were optional. Donor characteristics were assessed for association with positive cultures using the Fisher exact test and Poisson regression analyses. Incidence rates of ocular infections were estimated, and 95% confidence intervals were calculated. RESULTS: Cultures were performed in 784 (58.9%) of the 1330 cases. For the 0 to 7-day versus 8 to 14-day preservation time groups, respectively, positive fungal growth occurred in 10 of 397 (2.5%) versus 5 of 387 (1.3%) corneas (P = 0.30), whereas positive bacterial cultures occurred in 6 of 397 (1.5%) versus 4 of 387 (1.0%) corneas (P = 0.75). Surgeon-prepared tissue remained a significant risk for positive fungal cultures [relative risk (RR) of surgeon- versus eye-bank-prepared, 2.85; 95% CI (1.02-7.98)], whereas younger donors [RR per year of age, 0.96; 95% CI (0.93-1.00)] and accidental death donors [RR of accident versus disease, 3.71; 95% CI (1.36-10.13)] were at a greater risk for positive bacterial cultures. Fungal infection (Candida glabrata) developed in 1 (6.7%) of 15 recipients with a positive fungal culture, and no recipient infections occurred with positive bacterial culture. With one additional fungal keratitis (Candida albicans) and one bacterial endophthalmitis (E. coli) with no rim culture performed, a total of 2 of 1330 eyes (0.15%) developed fungal and 1/1330 eyes (0.08%) developed bacterial postkeratoplasty infections. CONCLUSIONS: A longer preservation time was not associated with a higher rate of positive donor rim cultures. The overall rate of infection across the entire cohort was low.
Authors: Jonathan Lass; Beth Ann Benetz; David D Verdier; Loretta B Szczotka-Flynn; Allison R Ayala; Wendi Liang; Anthony J Aldave; Steven P Dunn; Tryone McCall; Shahzad I Mian; Lisa C Navarro; Sanjay V Patel; Sudeep Pramanik; George O Rosenwasser; Kevin W Ross; Mark A Terry; Craig Kollman; Robin L Gal; Roy W Beck Journal: JAMA Ophthalmol Date: 2017-12-01 Impact factor: 7.389
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Authors: Beth Ann Benetz; Christopher G Stoeger; Sanjay V Patel; Robert C OʼBrien; Loretta B Szczotka-Flynn; Allison R Ayala; Maureen G Maguire; Harry J Menegay; Peter Bedard; Jameson M Clover; Pankaj C Gupta; Kristen E McCoy; Jonathan C Song; Jonathan H Lass Journal: Cornea Date: 2019-04 Impact factor: 3.152