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2018 Agenda and Abstracts | Next >

2018 OMIG Abstract

A Contaminated Eye Care Solution Used to Prepare Corneal Donor Tissue and the Association with a Cluster of Corneal Rim Cultures Positive for Achromobacterspp

Joseph B. Ciolino, Marlene L. Durand, Michael S. Gilmore, Maggie Lau, Paulo J. M. Bispo
Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School


Purpose: Donor cornea tissue may become contaminated during processing or storage in an eye bank, and culture of the donor rim at the time of corneal transplantation can provide helpful information to the ophthalmologist regarding a patient’s risk of developing a postoperative infection. We investigated a cluster of corneoscleral rim cultures positive for Achromobacterspp over a 6-month period in 2017 at Massachusetts Eye and Ear (MEE), although no patient developed a postoperative infection.

Methods: Corneoscleral donor rims were cultured in chocolate agar and meat broth for 7 days at 37°C with 5% CO2. Positive cultures were subjected to species identification and antimicrobial sensitivity testing using the MicroScanWalkAway system. Further identification was performed by 16S rDNA sequencing. Because the eye bank that supplied the donor corneas used a single brand of commercially available eye wash solution during this 6-month period but not subsequently, we also cultured a random sample of 6 bottles (same lot) of this brand of eye wash solution, storing the 6 bottles at room temperature and culturing 100µL aspirates at various times over 3 months.

Results: Between July and December 2017, 11 donor rims grew a non-fermenting Gram-negative rod phenotypically identified as closely related bacteria belonging to the genera Achromobacter, Alcaligenes, Ralstonia, Stenotrophomonas and Pseudomonas. Molecular identification performed on 8 available isolates proved them all to belong to the same genus Achromobacter. The 6 bottles of eye wash solution tested also grewAchromobacter spp., with fairly high bacterial loads (3.4x105 ± 1.1CFU/mL); bacterial loads were not diminished by longer storage duration. All isolates were resistant to gentamicin, amikacin, tobramycin, and aztreonam and susceptible to levofloxacin. None of the patients receiving a contaminated corneal tissue at MEE developed a postoperative infection.

Conclusion: An unusual organism, Achromobacter, grew from several donor corneocleral rims at a single eye institution over a 6-month period in 2017. During this same period, the supplying eye bank used a brand of eye wash solution in processing donor corneas that may have been contaminated with Achromobacter. No patient developed an infection.

Disclosure: N


2018 Agenda and Abstracts | Next >