Kornea saklama solüsyonlarının keratoplasti ameliyatı öncesi mikrobiyolojik incelenmesi
Küçük Resim Yok
Tarih
2004
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Kornea saklama solüsyonlarında bakteriyel kontaminasyonu mikrobiyolojik incelemelerle araştırmak ve olası bakteriyel endoftalmiyi penetran keratoplasti (PKP) öncesi dönemde önlemek. Gereç ve Yöntem: Ege Üniversitesi Tıp Fakültesi'nde Aralık 1998 ve Aralık 2003 tarihleri arasında, aseptik koşullarda alınan korneaların saklandığı Optisol GS (Chiron Vision, Clare-mont, CA, ABD) solüsyonu, bakteriyel kontaminasyon açısından mikrobiyolojik analiz yöntemleriyle incelendi. Bulgular: Mikrobiyolojik incelemeye alınan toplam 158 adet Optisol GS solüsyon örneğinden 154'ünde bakteriyel bulaşma saptanmadı ve bu solüsyonlarda saklanan greftler nakledildi. Solüsyon örneklerinin 151'i (= % 95.6) Anesteziyoloji ve Reanimasyon Anabilim Dalı Yoğun Bakım Ünitesi'nden, 7 tanesi (% 4.4) acil servisten bildirilen ölüm olgularından alındı. Bulaşma saptanan solüsyonların tümü anesteziyoloji ve reanimasyon yoğun bakım ünitesine ait olup, örneklerden birinde Pseudomonas aeruginosa, başka birinde Klebsiella pneumoniae ve diğer iki örnekte Staphylococcus epidermidis üredi. Mikrobiyolojik inceleme öncesi dönemde kliniğimizde yapılan 150 PKP ameliyatı sonrası 2 endoftalmi görülmüşken (%1.33), sonraki dönemde yapılan 308 PKP'de endoftalmi görülmedi (%.0.00), bu fark istatistiksel açıdan anlamlı bulunmuştur (p=0.042, ki-kare testi). Sonuç: Donör korneaların kornea alımı öncesi veya alım sırasında kontamine olma olasılıkları vardır. Kornea saklama solüsyonlarının, korneaların alımından itibaren toplam 72 saat içinde sonuç veren bir mikrobiyolojik incelemeyle değerlendirilmelerinin, keratoplasti ameliyatlarının programını geciktirmeyen, bu arada görmeyi tehdit edici enfeksiyon riskinden koruyan değerli bir yöntem olduğu sonucuna varıldı.
Purpose : To investigate the bacterial contamination of corneal storage solutions by microbiological analysis for preventing possible bacterial endophthalmitis at preoperative period. Methods : Between December 1998 and December 2003. Optisol GS solutions (Chiron Vision, Claremont, CA, USA) in which donor corneas excised from cadavers in aseptic conditions were stored, have been analyzed for bacterial contamination by microbiologic analysis method. Results : No bacterial contamination was detected in 154 of the 158 microbiologically analyzed Optisol GS solutions, and corneal grafts stored in these solutions were transplanted. One hundred fifty one pair of grafts (=95.6 %) were excised from the cadavers in Anesthesiology and Reanimation Department Intensive Care Unit and 7 pair of grafts (=4.4 %) excised from cadavers in Emergency Service. All of the culture positive materials were obtained from Anesthesiology and Reanimation Department Intensive Care Unit and isolated bacteriae were Pseudomonas aeruginosa in one sample. Klebsiella pneumoniae in another sample and Staphylococcus epidermidis in other two samples. Of 150 PKP surgeries which were performed without microbological analysis before this study. 2 (1.33 %) bacterial endophthalmitis were observed. However, of the 308 PKP surgeries which were performed after microbiological analysis, no (0.00 %) endophthalmitis was observed. This difference was found statistically significant (p=0.042, Chi-square test). Conclusion : Donor corneas might be contaminated before or during the excision. Microbiological analysis of corneal storage solution before penetrating keratoplasty is a valuable method which prevents the risk of bacterial infection and because of the culture results are obtained within 72 hours from the beginning of corneal excision, it does not delay the schedule of penetrating keratoplasty procedure.
Purpose : To investigate the bacterial contamination of corneal storage solutions by microbiological analysis for preventing possible bacterial endophthalmitis at preoperative period. Methods : Between December 1998 and December 2003. Optisol GS solutions (Chiron Vision, Claremont, CA, USA) in which donor corneas excised from cadavers in aseptic conditions were stored, have been analyzed for bacterial contamination by microbiologic analysis method. Results : No bacterial contamination was detected in 154 of the 158 microbiologically analyzed Optisol GS solutions, and corneal grafts stored in these solutions were transplanted. One hundred fifty one pair of grafts (=95.6 %) were excised from the cadavers in Anesthesiology and Reanimation Department Intensive Care Unit and 7 pair of grafts (=4.4 %) excised from cadavers in Emergency Service. All of the culture positive materials were obtained from Anesthesiology and Reanimation Department Intensive Care Unit and isolated bacteriae were Pseudomonas aeruginosa in one sample. Klebsiella pneumoniae in another sample and Staphylococcus epidermidis in other two samples. Of 150 PKP surgeries which were performed without microbological analysis before this study. 2 (1.33 %) bacterial endophthalmitis were observed. However, of the 308 PKP surgeries which were performed after microbiological analysis, no (0.00 %) endophthalmitis was observed. This difference was found statistically significant (p=0.042, Chi-square test). Conclusion : Donor corneas might be contaminated before or during the excision. Microbiological analysis of corneal storage solution before penetrating keratoplasty is a valuable method which prevents the risk of bacterial infection and because of the culture results are obtained within 72 hours from the beginning of corneal excision, it does not delay the schedule of penetrating keratoplasty procedure.
Açıklama
Anahtar Kelimeler
Göz Hastalıkları
Kaynak
Türk Oftalmoloji Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
34
Sayı
5
