Conjunctival Bacteria Flora of Glaucoma Patients During Long-Term Administration of Prostaglandin Analog Drops

Abstract

PURPOSE.To investigate the effects of the long-term use of prostaglandin analogs for glaucoma treatment on the indigenous flora of the conjunctiva.METHODS. Bacterial isolates were collected from the conjunctival sacs of 68 patients at Miyata Eye Hospital from February to September 2014, who had been receiving continuous monotherapy with prostaglandin analogs for glaucoma for at least 1 year. Minimum inhibitory concentrations of levofloxacin, gatifloxacin, moxifloxacin, cefmenoxime, tobramycin, chloramphenicol, and erythromycin against the isolates were measured to determine susceptibility. RESULTS.The positive culture rate in all cases was 90.5% (57/63 eyes), and a total of 79 bacterial strains were isolated. The isolated bacteria included aerobic gram-positive cocci (8% Staphylococcus aureus and 41% Staphylococcus epidermidis), coagulase-negative staphylococci (5%), Streptococcus spp. (1%), Corynebacterium spp. (4%), gram-negative bacteria (4%), and the facultative anaerobe Propionibacterium acnes (33%). The positive culture rates for patients using 0.005% latanoprost (Xa group) and 0.004% travoprost (Tz group) were 88.9% and 92.6%, respectively, with no statistically significant difference in the composition of isolated bacteria between groups. Methicillin-resistant S. epidermidis (MRSE) was significantly more frequently isolated in the Xa group. The antimicrobial susceptibility rates of S. epidermidis were significantly lower in the Xa group for levofloxacin, gatifloxacin, moxifloxacin, and tobramycin.CONCLUSIONS. The indigenous flora may be affected by the long-term use of prostaglandin analogs. The higher incidence of MRSE in the Xa group should be considered during the longterm, continuous administration of eye drops, such as in glaucoma treatment.

Effect of clinical parameters on the ocular surface microbiome in children and adults

“…Although our cohort of patients did not demonstrate a difference in the microbial composition between individuals using topical medications, other studies do suggest that long-term use of topical medications does affect the OSM. 24 It is possible that the individuals had not used the medications for a sufficient length of time to induce change and/or that our cohort was not large enough to fully evaluate this finding. Additionally, our patients often had ocular morbidities and/or topical ocular medication use, which is also not reflective of the general population.…”

Bacteriological profiles and drug susceptibility of Streptococcus isolated from conjunctival sac of healthy children

“…Although there are a number of studies reporting the presence of bacteria in the conjunctival sac, these works were conducted in patients suffering from various eye diseases, such as Stevens -Johnson syndrome and cataracts [5,6]. These works show that the microbial flora may change as a result of surgery [7,8], use of antibiotics [9] and even seasonal change. For instance, it was found that conjunctival bacteria in patients undergoing cataract surgery presented a seasonal prevalence pattern where different bacteria were identified in different seasons [10].…”

Benzalkonium Chloride Resistance in Staphylococcus epidermidis on the Ocular Surface of Glaucoma Patients Under Long-Term Administration of Eye Drops

“…In a previous study, we reported that methicillin-resistant S. epidermidis occurred more frequently on the ocular surface of glaucoma patients subjected to the long-term use of Xa compared to that for subjects treated with Tz. 10 These isolates were obtained from the indigenous flora of the conjunctiva of glaucoma patients treated with prostaglandin analog monotherapy for at least 1 year. In the current study, we analyzed these S. epidermidis isolate stocks and found that those obtained from the ocular surface of glaucoma patients under Xa treatment exhibited resistance to BAC as indicated by higher MIC values ( Table 2 ), and, especially, methicillin-resistant isolates were significantly resistant to BAC.…”

“…Our previous study showed that methicillin-resistant Staphylococcus epidermidis (MRSE) was isolated more frequently in patients treated with 0.005% latanoprost (Xalatan [Xa]; Pfizer, Inc., New York, NY), which contains BAC, than in patients treated with 0.004% travoprost (Travatan Z [Tz]; Alcon Japan Co. Ltd., Tokyo, Japan), which does not contain BAC. 10 In the current study, we aimed to clarify the factors related to the methicillin susceptibility of S. epidermidis in the conjunctival flora. Specifically, we analyzed the susceptibility of S. epidermidis isolated in our previous report 10 to main prostaglandin agents and BAC and examined whether the isolated S. epidermidis contained the qacA/B and qacC/smr genes.…”

“…10 In the current study, we aimed to clarify the factors related to the methicillin susceptibility of S. epidermidis in the conjunctival flora. Specifically, we analyzed the susceptibility of S. epidermidis isolated in our previous report 10 to main prostaglandin agents and BAC and examined whether the isolated S. epidermidis contained the qacA/B and qacC/smr genes.…”