Current pattern of antibiotic resistance of clinical isolates among conjunctival swabs

Abstract

Objectives: To identify the etiological agent in bacterial conjunctivitis and to determine the antibiogram of bacterial isolates. Methodology: This observational study was conducted at Dr. Essa’s Laboratory over a period of 12 months ending in March 2012. Two hundred samples taken from conjunctiva of patients with conjunctivitis were cultured on routine medium and the antibiograms of bacterial isolates were determined by Kirby- Bauer disc diffusion method. Results: The analysis of the culture showed that 41% were cultured positive with gram positive bacteria Staphylococcus aureus 52.5% and Staphylococcus epidermidis 30.1% and Micrococci 8.3%. However, 9.1% were gram negatives with Klebsiella pneumoniae 5.14% and Pseudomonas aeruginosa 2.6% and 1.36% were others (Acinetobacter, Haemophilus , E.coli and Moraxella) keeping in view the increasing use of contact lens and unclean fingers. The overall antibiograms of bacterial isolates indicate aminoglycosides (gentamicin, tobramicin) and the newer quinolones as apparent drug of choice for empirical therapy, followed by chloramphenicol, since drug fussy gram-negatives such as Pseudomonas, Acinetobacter and E.coli were among the conjunctival isolates. Resistance profile of gram positive isolates shows cefixime 91.4%, doxycycline 57.9%, cotrimoxazole 29.3%, ampicillin 22.9%, ciprofloxacin 13.4%, cephradine 8.3%, cefuroxime 7.1%, fosfomycin 4.7%, ceftriaxone 3.6%, co-amoxiclav 3.6%, cefotaxime 3.5%, vancomycin 2.6%. Conclusion: Resistance to all conventionally used antibiotics is increasing, therefore identification of etiological agent and antibiogram is important to treat conjunctivitis and to avoid complications.

Ocular bacterial infections at Quiha Ophthalmic Hospital, Northern Ethiopia: an evaluation according to the risk factors and the antimicrobial susceptibility of bacterial isolates

“…Staphylococcal isolates were predominant among patients with conjunctivitis, blepharitis and blepharoconjunctivitis diagnoses, similar to that in patients from Jimma [6], Nigeria [23], and Columbia [48]. Conversely,, CoNS isolates were more frequent in keratitis (17%) and endophthalmitis (28.6%) diagnoses, as has been reported in Uganda [49], Mexico [50], Australia [8], Pakistan [51] and India [52]. …”

Bacterial profile of ocular infections: a systematic review

“…In Individuals with underlying disease such as diabetic mellitus and rheumatoid arthritis, the diminished immunity may result in loss of control of systemic infections with subsequent spread to ocular tissues especially in endophthalmitis [ 62 , 71 ]. This has also been evidenced in case of K. pneumoniae endophthalmitis infections and M. catarrhalis keratitis infections [ 72 , 73 ] In addition, age might be a factor due to waning immunity and susceptibility to bacterial ocular infections [ 13 , 74 ]. Operative procedures, prophylactic measures and topical use of corticosteroids are also good predisposing factors for bacterial ocular infections associated with the immune suppression and inability to kill some organisms like P. aeruginosa and S. epidermidis [ 12 , 59 ].…”

Bacterial Spectrum and Antibiotic Resistance Patterns of Ocular Infection: Differences between External and Intraocular Diseases

“…In the New York Eye and Ear Infirmary, Adebayo and colleagues reviewed 12 years of data from their hospital and found that, among 20,180 conjunctival bacterial cultures, 60.1% were culture-positive and S. aureus was the most common pathogen; in addition, moxifloxacin and gatifloxacin currently appear to be the best choice for empirical broad-spectrum coverage [ 7 ]. Additionally, other reports on the ocular bacterial infection and antibiotic susceptibility have been reported in the literature from various countries, like Colombia [ 8 ], Pakistan [ 9 ], Italy [ 10 ], and Uganda [ 11 ], among other locations.…”