Bacterial contamination of multi-dose eye drops at ophthalmology department, University of Gondar, Northwest Ethiopia

Abstract

PURPOSE:Ophthalmic solutions used for both diagnostic and therapeutic purposes were found to be contaminated with bacteria pathogens and caused serious ocular infections such as keratitis and endophthalmitis. The objective was to assess the magnitude and pattern of bacterial contamination of multi-dose ophthalmic medications and investigate the drug susceptibility pattern of the isolates in the Department of Ophthalmology at Gondar University Teaching Hospital.METHODS:A total of 100 ophthalmic medications in-use by patients and eye-care workers have been taken and cultured for potential bacterial contamination in the Microbiology Department after 1 week and >1 week of use. The dropper tip and the residual eye medications were examined for contamination. The contaminating bacteria were identified using a standard procedure and drug susceptibility testing to selected antimicrobial agents was done.RESULTS:Eleven ophthalmic medications were contaminated by different bacterial species with a prevalence of 11%. Multi-use and longer duration of use of eye medications were associated with higher rate of contamination. The contamination level ranges from 0% for antibiotics, 20% for local anesthetics, and 40% for povidone iodine. Among bacteria identified, Staphylococcus aureus and coagulase-negative Staphylococcus species were resistant to methicillin while others were sensitive to the antibiotics tested.CONCLUSION:The prevalence of contamination was low, but methicillin-resistant Staphylococcus was a potential risk. It is recommended that the Department of Ophthalmology should design set of rules about duration of use and safe handling of ophthalmic medications by the staff and patients.

Stability and Safety Traits of Novel Cyclosporine A and Tacrolimus Ophthalmic Galenic Formulations Involved in Vernal Keratoconjunctivitis Treatment by a High-Resolution Mass Spectrometry Approach

“…As previously reported in literature, the risk of eye drops contamination is related to reuse of these therapeutic presidium and to its duration of use [26][27][28]. As such, it should be pointed out that further investigations would be needed to evaluate whether multi-dose eye medication could be contaminated by bacteria attributable to a potential incorrect user handling.…”

Microbial Contamination and Antimicrobial Resistance in Use of Ophthalmic Solutions at the Department of Ophthalmology, Jimma University Specialized Hospital, Southwest Ethiopia

“…Commonly identified Gram-positive bacteria in different reports include coagulase-negative Staphylococci [15], Corynebacterium species, Propionibacterium species, as well as Staphylococcus aureus , Bacillus species, Micrococcus species, and Enterobacter species [2, 16]. Potentially pathogenic Gram-negative organisms were significantly isolated from all medication sites than Gram-positive organisms.…”

“…Apart from the risk of infection, bacterial contamination of eye drops may alter the pH of the solution and therefore reduce the efficacy of the drug [10, 19]. Even though medication contamination is clinically important, little attention has been paid to the proper and aseptic method of preparation of eye drops in this specialized teaching hospital and limited studies exist in the country in general [15, 17]. Therefore, the aims of this study were to determine the magnitude and pattern of microbial contamination of in-use eye drops at the Department of Ophthalmology, Jimma University, Ethiopia.…”

To Study the Safety of Multi-dose Topical Anaesthetic Eye Drops One Month after Opening

“…It is a common practice to use a single bottle of topical formulations in different patients with different complaints. Asegedech Tsegaw and colleagues found out that multi-dose eye drops are easily contaminated due to frequent and long-term usage and may result in inadvertent damage to ocular surfaces by causing unwanted infections 9 . Nentwich MM and co-authors conducted a similar study in Kenya on 101 bottles of multi-use and single-use topical ophthalmic solutions with similar conclusions 10 .…”