title: Risk factors for donor cornea contamination:  retrospective analysis of 4546 procured corneas in a single eye bank.
abstract: OBJECTIVE
  Microbiological contamination is a common cause for elimination of organ-cultured donor corneas. The aims of the present study were to analyze contamination rates and identify risk factors for contamination.
  
  
  METHODS
  Retrospectively, the contamination rates of 4546 organ-cultured corneas and the causative species were studied. The impact of sex, age, death-to-explantation interval, explantation technique, cause of death, and mean monthly temperature on contamination rate was analyzed.
  
  
  RESULTS
  The median annual contamination rate was 5.3% (range: 3%-19%). Most contaminations were of fungal origin (61.9%), with Candida species (45%) being predominant. Bacterial contaminations (34.4%) were dominated by Staphylococcus species (12.8%). Sex, donor age, and mean monthly temperature had no statistically significant influence on the contamination rate. The median death-to-explantation interval of contaminated corneas (44 hours) was longer than that of sterile corneas (39 hours; P < 0.001; n = 4437). Cardiopulmonary failure was associated with the highest contamination rate (13.6%) of all death causes. The switch from whole globe to in situ excision was followed by a temporary increase in contamination rate (12.5%-19.4%).
  
  
  CONCLUSIONS
  Although the genesis of donor cornea contamination seems to be multifactorial, resident species from physiological skin flora are the main contaminants indicating that the donor corpses could be the main source of microbiological contamination. A change in the explantation technique was followed by an increase in the contamination rate.
authors.affiliation: Department of Ophthalmology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. slinke@uke.uni-hamburg.de
authors.forename: Stephan J
authors.initials: SJ
authors.lastname: Linke
authors.forename: Otto H
authors.initials: OH
authors.lastname: Fricke
authors.forename: Mau-Thek
authors.initials: MT
authors.lastname: Eddy
authors.forename: Jürgen
authors.initials: J
authors.lastname: Bednarz
authors.forename: Vasyl
authors.initials: V
authors.lastname: Druchkiv
authors.forename: Paul-Michael
authors.initials: PM
authors.lastname: Kaulfers
authors.forename: Birgit
authors.initials: B
authors.lastname: Wulff
authors.forename: Klaus
authors.initials: K
authors.lastname: Püschel
authors.forename: Gisbert
authors.initials: G
authors.lastname: Richard
authors.forename: Olaf J C
authors.initials: OJ
authors.lastname: Hellwinkel
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001419:Bacteria / Q000302:isolation & purification*; D002452:Cell Count; D003315:Cornea / Q000382:microbiology*; D016039:Corneal Transplantation; D003470:Culture Media; D004728:Endothelium, Corneal / Q000473:pathology; D005125:Eye Banks / Q000706:statistics & numerical data*; D005260:Female; D005658:Fungi / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009924:Organ Culture Techniques; D009926:Organ Preservation / Q000379:methods; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D012621:Seasons; D014019:Tissue Donors / Q000706:statistics & numerical data*; D009927:Tissue and Organ Procurement
chemical_list: D003470:Culture Media