The Efficacy of Postenucleation Saline Wash and the Effect of Different Antimicrobial Agents on Microbial Contamination of Donor Eyes

Abstract

Objectives: To evaluate the efficacy of postenucleation saline wash and the effect of different antimicrobial agents on the microbial contamination of donor eyes. Methods: Two hundred donor eyes were given saline wash and treated with any one of the following 5 randomly selected antimicrobial solutions: 1% povidone-iodine for 3 min, 0.3% gentamycin for 10 min, 0.3% ciprofloxacin for 10 min, a combination of neomycin 1,700 IU, gramicidin 0.025% and polymyxin B 5,000 IU (Neosporin®) for 10 min and a combination of 0.3% amikacin for 10 min, followed by 2.5% cefazolin for 10 min. Limbal swabs were sent for culture before and after saline wash and after treatment with antimicrobial agents. Results: On culture of the pretreatment swabs, 77.5% were positive for growth with 75.5% bacterial and 11.5% fungal. Coagulase-negative Staphylococcus (29.1%) was the most common bacterial contamination followed by Pseudomonas aeruginosa (18.5%), Acinetobacter sp. (18.5%) and Alcaligenes faecalis (13.2%). A 20-ml sterile saline wash resulted in a 20% decrease (p < 0.01) in the amount of contamination. The maximum antimicrobial effect with regard to bacterial decontamination was achieved with povidone-iodine (64% decrease in the amount of contamination, p < 0.01) followed by ciprofloxacin (47.6% decrease, p < 0.05), the combination of cefazolin and amikacin (42.5%, p < 0.05), Neosporin (38.5%, p < 0.05) and then gentamycin (21.7%, p = NS). Conclusions: A thorough saline wash and treatment with 1% povidone-iodine for 3 min is a more effective method for the decontamination of donor eyes as compared to most currently available and frequently used antibiotics.

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“…[11] Noteworthy findings include that saline wash leads to a 20% decrease in microbial load, further instillation of 1% povidone-iodine for 3 min is most effective compared to the application of antibiotics such as ciprofloxacin, combination of cefazolin and amikacin, Neosporin and gentamycin. Use of 5% povidone-iodine and amikacin was found to be better than 1% povidone-iodine and gentamicin but still not adequate to eliminate all Gram-negative organisms.…”

Ocular adnexal lymphoma: no evidence for bacterial DNA associated with lymphoma pathogenesis

“…While Acinetobacter infection was previously reported to coexist with MALT lymphoma in the fallopian tube (Noack et al , 2002), it also represents the most common microbial contamination of eye specimens, detected in the corneas of 13·2% of donors. (Panda et al , 2006). Acinetobacter also represents the most common hospital contaminant and colonizes the skin of the forearms in 51% of healthy volunteers (Berlau et al , 1999), making surgeon‐to‐sample or pathologist‐to‐sample transmission highly likely.…”

Seleção de córneas para transplantes

“…A superfície de cerca de 80% dos olhos enucleados apresenta-se colonizada por bactérias (2) . O perigo dessa contaminação é a transferência de germes, do enxerto para o interior do olho receptor, desencadeando infecção intraocular (3,4) .…”