Clinical characteristics of external bacterial ocular and periocular infections and their antimicrobial treatment patterns among a Ghanaian ophthalmic population

Abstract

Empirical antimicrobial therapy is linked to a surge in antimicrobial resistant infections. However, an insight on the bacteria etiology of ocular infections is essential in the appropriation of choice of antimicrobial among clinicians, yet there remains a dearth of data from Ghana. We investigated the bacteria etiology of external ocular and periocular infections and antimicrobial treatment patterns among a Ghanaian ophthalmic population. A multicenter study design with purposive sampling approach was employed. Patients demographics and clinical data were collated using a pretested structure questionnaire. Cornea specimens and conjunctival swabs were obtained for bacterial isolation following standard protocols. About 95% (98/103) of ocular samples were positive for bacteria culture. The proportion of Gram-negative bacteria was 58.2%, and the predominant bacteria species were Pseudomonas aeruginosa 38.8% and Staphylococcus aureus 27.6%. Conjunctivitis 40.0% and keratitis 75.0% were mostly caused by Pseudomonas aeruginosa. The routinely administered antimicrobial therapy were polymyxin B 41.2%, neomycin 35.1% and ciprofloxacin 31.6%. Participants demographic and clinical characteristics were unrelated with positive bacteria culture (p > 0.05). Our results showed a markedly high burden of ocular bacterial infections and variations in etiology. Bacterial infection-control and antimicrobial agent management programs should be urgently institutionalized to prevent the emergence of resistant infections.

Elucidating fungal etiology and multi-drug resistance in oculomycosis and bioprospecting native medical plants as candidates for antifungal therapy

“…Ophthalmia neonatorum is a type of neonatal conjunctivitis that occurs within the rst 28 days of life and is characterized by signs such as eyelid edema, erythema, and purulent discharge. Preseptal and orbital cellulitis showed similar features of painful swelling and/or tenderness of the eyelid with the later distinguished from the former by decreased vision and pain on eye motility 14 .…”

“…However, in resource-constrained settings such as Ghana, the lack of rapid molecular diagnostics and high throughput screening facilities offset most consulting ophthalmic clinicians to mainly rely on clinical features in diagnosing and managing oculomycosis. Speci cally, eyecare professionals perform comprehensive patient history to collate patients' symptoms and gross ophthalmic assessments by slit-lamp biomicroscopy, ophthalmoscopy, and visual acuity to recognize peculiar clinical signs and employ broad-spectrum antimicrobial treatment therapy 13,14,15 . Such clinical practice results in an inability to establish etiologic agents before treatment and leaves a worrying dearth of evidence on ocular fungal isolates commonly implicated in oculomycosis among ophthalmic patients in Ghana 14 .…”

A novel ex vivo bovine corneal infection and clearance model for Neisseria gonorrhoeae, Staphylococcus aureus, and Pseudomonas aeruginosa

“…P. aeruginosa and S. aureus are also implicated in the aetiology of ophthalmia neonatorum [152][153][154][155][156][157], as well as microbial keratitis in adults including in cases of contact lens wear [7,[158][159][160][161][162][163][164][165][166]. Fluoroquinolones have also been used for treatment of ophthalmia neonatorum [143] and microbial keratitis [166][167][168][169].…”

A Review on Pathogens and Necessary Diagnostic Work for Bleb-Related Infections (BRIs)

“…After the isolates have been identified, an antibiotic susceptibility test should be performed to determine the most effective drug for therapy [ 40 , 41 , 42 ]. Apart from the minimum inhibitory concentration (MIC) of the antibacterial agents, the minimum bactericidal concentration should be determined as well.…”

“…Apart from traditional microbiologic assays, molecular diagnostic tools are also available for the detection of culture negative cases via real-time polymerase chain reaction (PCR) [ 42 , 49 , 50 ]. Bispo et al, in a study with 31 samples, were able to estimate an improvement from 47.6% to 95.3% in detecting bacteria using real-time PCR [ 49 ].…”