Intensive care unit time and prolonged enucleation to processing interval are associated with donor cornea contamination.

Abstract

To determine donor cornea contamination rate and to determine factors associated with cornea contamination. To assess the effect of hospitalization, intensive care unit (ICU) time, and antibiotic use on corneal contamination rate. To determine the spectrum of the contaminating microorganisms. The contamination rate of 212 corneas, obtained by enucleation from April 2014 to January 2015 in a single eye bank, was assessed retrospectively according to age, sex, cause of death, systemic antibiotic use, hospitalization time, ICU time, mechanical ventilation (MV), death to enucleation interval (DEI), enucleation to processing interval (EPI), and corneal epithelial exposure grading. The relative risk (RR) and adjusted RR with a 95% confidence interval were calculated using IBM-SPSS 20.0. The contamination rate was 35.6% (n = 75). On multivariate analysis, ICU stay of 4days or longer and enucleation to processing interval (EPI) greater than 7.4h (RR 1.58, CI 0.96-2.60, P= 0.06) were associated with donor cornea contamination. Corneal contamination risk was highest from 4 to 6days at the ICU (RR 3.40, CI 1.54-7.51, P< 0.01) and decreased after 7days (RR 2.22, CI 1.00-4.93, P= 0.05). Coagulase-negative Staphylococcus was the most common isolated bacteria (69.6%). The frequency of gentamicin-resistant bacteria was higher among patients who stayed 4days or longer at the ICU. Patients staying at the intensive care unit 4days or longer showed increased risk of corneal contamination. This is an important result to consider further indication for cornea donation.