長庚醫院75年至78年6月的眼球及角膜保存液的陽性培養率調查報告

The Study of Contamination of Donor Corneal Preservation in Chang Gung Memorial Hospital (1986 to June, 1989)

蔡瑞芳(Ray Jue-Fang Tsai) ； 傅祖耀(Chou-Yow Bo)

《中華民國眼科醫學會會刊》 29卷2期 (1990/05) Pp. 774-780

https://doi.org/10.30048/ACTASOS.199005.0133

摘要

本文提出90隻斯里蘭卡獅予會所捐贈的眼球，16隻角鞏膜片及104雙由本地所捐贈的眼球，利用其在不同條件下的保存液來作微生物培養，而得到的陽性結果報告。從斯里蘭卡直接保存眼球的E-P medium，其陽性培養率為50%。這些眼球所取下來的角鞏膜片，用M-K medium renurture後的陽性培養率降為8.8%；其中有一例產生錬球菌眼內炎。其它16隻由M-K medium直接保存運送的培養率為31.2%；亦有一例產生錬球菌眼內炎。而對本地所捐贈眼球的M-K medium保存液作培養，所得的陽性培養率為7.7%；其中有一例產生綠膿桿菌所引起的角膜潰瘍。在45隻的陽性培養中，培養出細菌的比例佔了91%，而黴菌佔了44.4%。但經過處理及renurtune後，則明顯降低。因此運送中的污染及保存液的污染，可造成微生物的滋生，對授贈者的眼眼可能造成直接的傷害，我們應特別留意。

並列摘要

In the past few years, the donor corneas, which were used for PKP in Chang Gung Memoral (CGMH), more than half were supplied from Sri Lanka International Eye Bank (SLIEB), parts from domestic donation. Most of these donor eyes of SLIEB were processed as eye ball preservation method, were preserved in the E-P solution then shipped to Taiwan. Only some of them were preserved with corneosclera (C-S) button in M-K medium. it took at least 48 hours for shipping. For these donor corneas, contaminations of preserved media or tissue itself became crucial factor for the progrosis of patients after PKP.
In this paper, we studied the contaminations of bacteria and/or fungi from (a). E-P media from SLIEB (90 cases). (b). renurtured media for SLIEB eyes (90 cases). (c). M-K media from SLIEB (16 cases). (d). M-K media from domestic eyes (104 cases), which were used for performing PKP in CGMH in the period from 1986 to 1989. The postive results for bacteria and fangi contamination from (a)is 45/90=50%, (b) is 8/90=8.8%, (c) is 5/1631.2%, (d) is 8/10=7.7%. In (a), the positive result for fungi is 20/45=44.4%, bacteria is 41/45=91.1%. The clinical outcome of PKP by using the corneas from (b), is one endothalmitis in 8 cases of positive culture (12.5%) (B-streptococcus in both M-K medium and vitrous). The clinical outcome of PKP by using the corneas from (c), is one endophthalmitis in 5 cases of positive culture(20%). No any endophthalmitis is found in (d).

並列關鍵字

M-K McCarey-Kaufman medium ； E-P medium ； Renurture ； Endophthalmitis. Penetrating Keratoplasty