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

Abstract

Background. Eye drops are most frequently used medications in ophthalmology. The carriage of pathogenic organisms to eyes through the agency of eye drops has presented a serious problem for several decades. The objective of this study was to determine the magnitude of contamination and pattern of antimicrobial resistance of in-use ophthalmic solutions. Method. A cross-sectional study was conducted at the Department of Ophthalmology, Jimma University Specialized Hospital (JUSH), Southwest Ethiopia, from June to December 2015. Samples from all ophthalmic solutions from outpatient department, operation theaters, and wards after an average duration of use of two weeks were taken. Samples were cultured and organisms were identified; antimicrobial susceptibility testing was performed using standard microbial identification techniques. The data were analyzed using SPSS software. Chi-square test was done and associations were taken as significant if P<0.05. Result. The rate of contamination of eye drops in the study setup was found to be 51/70 (72.8%). Frequency of contamination of eye drops found was to be statistically associated with the duration of use of eye drops. Contaminations of eye drops were high among patients who self-administer the medications and those individuals who apply the medication less frequently. Tips of the bottles were more often contaminated than the content of the eye drop. Majority of both Gram-positive and Gram-negative organisms were sensitive for most of the broad-spectrum antibiotics; however, there were a significant number of Gram-negative organisms resistant to almost all antibiotics used. Conclusion. There is high rate of contamination of eye drops in the setup (72.8%). Duration of use of eye drops is a significant factor associated with contamination. Knowing duration time of each container and patient education on eye drop administration technique are mandatory.

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.…”

Bacterial Pathogens and Their Antimicrobial Resistance Patterns of Inanimate Surfaces and Equipment in Ethiopia: A Systematic Review and Meta-analysis

“…Bacterial contamination of inanimate surfaces and equipment is problematic to overcome as it can serve as a reservoir for an unlimited period through a gradual cross-transmission of pathogens and subsequent contact with patients and HCWs at a time of disease management [8]. It can be caused by a range of bacterial (both Gram-positive and Gram-negative isolates) and fungal species [9][10][11][12]. A highly virulent pathogen such as Staphylococcus aureus (Methicillin-resistant Staphylococcus aureus or MRSA), Coagulase-negative Staphylococci (CoNS), Enterococcus species (vancomycin-resistant Enterococci), Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Clostridium difficile, and Acinetobacter baumannii are capable of harbouring on contaminated inanimate surfaces and medical apparatus [5].…”

“…Nosocomial infections can be either emerged from endogenous microflora of the patient during antibiotic therapy or acquired from the exogenous inert environment that plays an important role in the potential reservoir to the microorganism of horizontal infection transmission [5,15,16]. In the hospital setting, inanimate surfaces such as mattresses, bed frames, doorknobs, mobile phones, and ophthalmic solutions/eye drops [12] from various wards or units and several medical types of equipment such as stethoscopes, portable radiograph, and ultrasound instruments are the key reservoir for medically important pathogens. Various equipment in the healthcare setting can be utilized in a patient zone for both monitoring and therapeutic purposes.…”

“…Decontamination with the use of physical or chemical means to remove and inactivate the contaminant pathogens from the surfaces of the hospital environment in order to provide a safe environment for handling of the patient is essential [12,24,25]. Not only decontamination processes but also disinfection, cleaning, and sterilization are very important steps to be done for a reusable item safe for further medical use.…”

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

“…Topical medications are easy to get contaminated and the rate of contamination is directly related to multiple use and also to duration for which the drops are being used 3,4 .…”