A study on isolation rate and prevalence of drug resistance among microorganisms isolated from multiorgan donor and donor corneal rim along with a report on existence of bla NDM-1 among Indian population.

Purpose: To study the rate of isolation and prevalence of drug resistance among bacteria isolated from conjunctival swabs collected from multiorgan donor and Donor corneal rim specimens obtained from a tertiary eye hospital in South India.

Methods: Donor corneal rims (DCR) and conjunctival swabs from multiorgan donors collected over a period of 6 months were screened for the prevalent species of bacteria and drug resistance associated with them against the first line of antibiotics by phenotypic methods and multidrug resistant isolates were further subjected for genotypic analysis.

Results: Seventy-six DCR specimens were screened out of which 46 (60.5%) specimens showed bacterial growth, the predominant isolate being Coagulase negative Staphylococci, the rest 30 (39.5%) did not show any culture growth. All 42 (100%) conjunctival swabs collected from multiorgan donors were positive for bacterial culture, the prevalent species once again, being Coagulase negative Staphylococci. Among the other gram positive bacterial genus encountered were Streptococci, Bacillus, Diphtheroids and the gram negatives were Enterobacteriaceae and nonfermentors. Antibiotic resistance was significantly high among gram positive group. Seven (29.1%) gram negative isolates were positive for Extended Spectrum Beta Lactamases (ESBL's) by conventional and molecular method. A blaNDM -1 carrying Acinetobacter baumannii was isolated from a multiorgan donor.

Conclusion: Preexcision culture in multiorgan donor is necessary to prevent postoperative endophthalmitis. Preexcision culture and antibiotic susceptibility testing of bacterial isolates of DCR will aid in understanding antibiotic pattern as institution of correct antibiotic will prevent the emergence of postoperative endophthalmitis. Molecular methods help in reducing the turn-around time for understanding the drug resistance genotypes.