Endophthalmitis From Contaminated Donor Corneas Following Penetrating Keratoplasty

Cameron, J. A.; Antonios, Sobhi R.; Cotter, John B.; Habash, Nadim R.

doi:10.1001/archopht.1991.01080010056032

Cited by 96 publications

(83 citation statements)

References 23 publications

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“…The most-common causes of postsurgical exogenous endophthalmitis are gram-positive bacteria, including coagulase-negative Staphylococcus, diphtheroids, and Propionibacterium acnes (287). The mycotic causes of exogenous endophthalmitis, such as yeasts (principally Candida species, including Candida glabrata [42] and Candida famata [211]), were found only in the postsurgical group, whereas Fusarium species were found only in the posttraumatic and postkeratitis groups (205). Other Candida spp.…”

Section: Exogenous Endophthalmitismentioning

confidence: 99%

Fungal and Parasitic Infections of the Eye

Klotz

Penn

Negvesky

et al. 2000

Clinical Microbiology Reviews

181

145

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Section: Exogenous Endophthalmitismentioning

confidence: 99%

Fungal and Parasitic Infections of the Eye

Klotz

Penn

Negvesky

et al. 2000

Clinical Microbiology Reviews

181

145

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“…En distintas comunicaciones [45][46][47][48][49] , la incidencia de endoftalmitis post-implante oscila entre 0,04 y 2% 42 , pudiendo ser mayor que la asociada a cirugía de catarata (0,1 a 0,4%) 42 . Se considera que al menos en 50% de estas infecciones, la fuente sería la córnea dadora, aunque no existen estudios de confirmación molecular.…”

Section: Introductionunclassified

Recomendaciones para el estudio microbiológico de tejidos preservados para implantes

E.²,

et al. 2004

Rev. chil. infectol.

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IntroducciónCada vez con mayor frecuencia existen patologías que requieren como parte de su terapia el uso de tejidos homólogos para implantes, los que han mejorado el pronóstico de estas enfermedades.Se ha descrito un aumento significativo del número de implantes de tejidos como válvulas Recomendaciones para el estudio microbiológico de tejidos preservados para implantes PATRICIA GARCÍA C., BÉATRICE HERVÉ E., CHRYSTAL JULIET L., EDUARDO TURNER G., CLAUDIO ARRETZ V., JULIO ARRIAGADA V., CLAUDIO RAFOLS DEL C., ALBERTO PÉREZ C., JORGE VILLEGAS C., GLORIA M. GONZÁLEZ G., PAULINA AGUIRRE H., JOSÉ MINGUELL U., MAURICIO OCQUETEAU P., ISABEL PIZARRO A., FRANCISCO ANDRIGUETTI C. y ALONSO RODRÍGUEZ B.Recommendations for the microbiological study of tissues preserved for implantsThe implant of tissues in Medicine has enhanced the prognosis and/or quality of life of several diseases, however its utilization is not free of risks for the receptor. Because of this, a carefully selection of live or cadaveric donors and the microbiological control of tissues before its utilization are very important procedures in securing the quality of the procedure. Contamination of tissues may be intrinsic (because of unnoticed infection in the donor) or extrinsic (after the tissues has been harvested). These recommendations focus into the microbiological control of extrinsic contaminations, through its handling during the tissues harvest or during its processing for preservation. Most frequently used implants in our country (cardiac valves, osseus tissue, skin, hematopoyetic precursor cells and cornea) are analyzed and methodology is described according to existing data in the literature and through a review of procedures employed in foreing centers. As no one of implants is completely sterile it is very important to analyze too the recommendations for handling contaminated cultures. As authors we expect that this document will be useful and in brief, we can exhibit national multicenter figures constructed with comparable methodologies.

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“…The solution of Optisol GS (Bausch ϩ Lomb, Irvine, CA) contains 100 g/ml gentamicin sulfate and 200 g/ml streptomycin sulfate. The possibility of adding antibiotics with a broader spectrum of activity, such as vancomycin, fluoroquinolones, and penicillin, has been evaluated, although such therapy could be ineffective against MDR pathogens (2,8). Studies aiming to evaluate the effects of antibiotics from the carbapenem or polymyxin class in preservation medium would be interesting and may represent an alternative method for treatment of multidrug-resistant P. aeruginosa.…”

mentioning

confidence: 99%

Pseudomonas aeruginosa Endophthalmitis after Penetrating Keratoplasty Transmitted from the Same Donor to Two Recipients Confirmed by Pulsed-Field Gel Electrophoresis

et al. 2011

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Two devastating cases of multidrug-resistant Pseudomonas aeruginosa endophthalmitis after keratoplasty as the result of transmission from the same donor were confirmed by pulsed-field gel electrophoresis. Strategies for preventing donor-to-host transmission, such as the use of antimicrobial agents of greater efficacy and better methods for detecting microorganisms in preservation medium, could minimize this type of transmission.In this paper, we describe two cases of early multidrugresistant (MDR) Pseudomonas aeruginosa endophthalmitis after penetrating keratoplasty as the result of transmission from the same donor. The cornea donor was a 38-year-old patient who died of cirrhosis 1 day before the surgeries. Donated corneas were collected with a death-to-preservation time of 2 h 45 min and were immersed in the preservative medium Optisol-GS (Bausch ϩ Lomb, Irvine, CA). The donor was treated under conditions that included mechanical ventilation and was not septic. Before his death, previously collected blood and urine for cultures gave negative results. The recipients were (i) a 76-year-old man presenting with bullous keratopathy who underwent an uneventful penetrating keratoplasty on his right eye in August 2009, and (ii) a 14-year-old male with keratoconus who underwent an uneventful penetrating keratoplasty on the right eye in August, 2009. On the first postoperative day, both recipients showed signs of infection in the donor corneal button. For both patients, treatment consisting of intravenous therapy with ceftazidime (2 g three times a day) and levofloxacin (400 mg once a day) and topical therapy with moxifloxacin (0.5%), cefazolin (50 mg/ml), and gentamicin (14 mg/ml) administered every hour following an initial loading dose of 1 to 2 drops every 5 min for the first 30 min was initiated on the first postoperative day. Subconjunctival injection of ceftazidime (200 mg) and vancomycin (20 mg) was performed. On the second postoperative day, intravenous therapy with imipenen (400 mg four times a day) replaced the ceftazidime therapy. Intravitreous injection of ceftazidime (10 mg/0.5 ml) and vancomycin (1 mg/1 ml) was also performed. Therapy using cefazolin eye drops was replaced by administration of imipenem (50 mg/ml). Despite prompt initiation of massive antimicrobial therapy, P. aeruginosa endophthalmitis was devastating to the infected eyes. In recipient 1, on the third postoperative day, visual acuity consisted of no light perception, leading to unavoidable evisceration of this eye; in recipient 2, a second keratoplasty and a vitrectomy were performed, and by postoperative day 20, visual acuity consisted of no light perception, leading to eye atrophy.The corneoscleral rim tissues were sent to the laboratory and cultured in Sabouraud medium (kept at room temperature for 30 days) and in thioglycolate medium (kept in an incubator at 37°C for 24 h) as part of our standard immediate post-cornealtransplant procedure. Afterward, Gram staining was done on the thioglycolate culture. In the presence of Gram-negative ...

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Endophthalmitis From Contaminated Donor Corneas Following Penetrating Keratoplasty

Cited by 96 publications

References 23 publications

Fungal and Parasitic Infections of the Eye

Fungal and Parasitic Infections of the Eye

Recomendaciones para el estudio microbiológico de tejidos preservados para implantes

Pseudomonas aeruginosa Endophthalmitis after Penetrating Keratoplasty Transmitted from the Same Donor to Two Recipients Confirmed by Pulsed-Field Gel Electrophoresis

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