title: Endophthalmitis by Pseudomonas aeruginosa. after penetrating keratoplasty, case report with an epidemiological investigation.
abstract: BACKGROUND
  An endophthalmitis following penetrating keratoplasty by Pseudomonas aeruginosa is a devasting case with very poor visual outcomes.
  
  
  OBJECTIVE
  To determine the origin of an infection after a penetrating keratoplasty.
  
  
  METHODS
  After an endophthalmitis an epidemiological study was undertaken with the approval of the ethics committee and support of a medical team comprised of an epidemiologist, infectologist, bacteriologist and ophthalmologists specializing in cornea. Factors that may have contributed to the risk of infection were assessed, for example, the processing and preservation of the cornea in the moment of the extraction, the characteristics of the donor, recipient and infecting bacterium, as well as the details pertaining to the surgical operation.
  
  
  RESULTS
  No risks factors were found in the institution, in the eye bank facilities, in the donor or in the receptor. However, sterile technique could not be guaranteed in the morgue where the corneal extraction occurred, and other isolated cases of endophthalmitis post-keratoplasty had been documented involving tissues from the same morgue that had been processed by two eye banks in the same city. Characteristics of the multi-resistant Pseudomonas sp. demonstrated its origin from a hospital environment due to its previous exposure to a variety of antibiotics.
  
  
  CONCLUSIONS
  Corneal extraction site must guarantee an antiseptic preparation and aseptic tissue donor recuperation; although in this study it was not feasible to accurately establish the infection source, all of the findings led to suspect a possible contamination at the morgue.
authors.affiliation: Unidad de Cirugía de Córnea y Refractiva, Grupo de Investigación Visión Sana, Clínica de Oftalmología de Cali, Colombia.
authors.forename: Claudia
authors.initials: C
authors.lastname: Blanco
authors.forename: María X
authors.initials: MX
authors.lastname: Núñez
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003315:Cornea / Q000382:microbiology; D003428:Cross Infection / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology*; D009877:Endophthalmitis / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology* / Q000382:microbiology*; D004866:Equipment Contamination; D005125:Eye Banks; D006801:Humans; D015948:Keratoplasty, Penetrating / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000188:drug therapy / Q000209:etiology / Q000382:microbiology*; D011552:Pseudomonas Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D012307:Risk Factors
chemical_list: D000900:Anti-Bacterial Agents