Ocular bacterial flora and antimicrobial susceptibility profile of a diabetic population in Cameroon: an analytical study

Abstract

The ocular flora can be a contributing factor to potentially devastating eye infections, especially under certain conditions such as diabetes. The aim of this study was to determine the influence of diabetes on the bacterial conjunctival flora and to assess its susceptibility to antibiotics. In an analytical cross-sectional study conducted in three hospitals in the department of Ndé-Cameroon, we included diabetic and non-diabetic participants. Samples were obtained by swabbing the lower conjunctival fornix. Gram stain and culture were performed and antibiotic sensitivity determined in case of bacterial growth. A positive culture was found in 33/40 (82.5%) diabetic participants and 16/40 (40%) non-diabetic participants. Diabetic participants showed a more frequent positive flora for Staphylococcus epidermidis, Bacillus, and Pseudomonas aeruginosa, while the majority of non-diabetic patient's flora were Bacillus, Staphylococcus epidermidis, and Staphylococcus saprophyticus. In diabetics, resistance of Staphyloccocus Coagulase-negative strains was observed in 80-100% of cases for Oxacillin and Trimethoprin-Sulfamethoxy. For Gram-negative strains, resistance was 80-100% for Penicillin, Oxacillin and Cefixime in diabetics. A positive culture was more frequently found in diabetic participants with a difference for the composition and antibiotic susceptibility compared to healthy people. This information may provide a better guideline for the prevention and the management of ocular diseases.

Ocular Surface Microbiome in Diabetes Mellitus

“…The culture-positive rate was shown to be higher in DM than non-DM group (21.7-94.13% and 4.3 -73.3%, respectively). [19][20][21][22][23] The result was reinforced by our study, although not statistically signi cant (15% and 5%, respectively; p=0.437). The lower culture-positive rate in our study may be due to different specimen collection and culture techniques.…”

“…13,18 The previous reports showed more bacterial colonization and the presence of gram-negative bacteria on the ocular surface of the DM than in the non-DM groups. [19][20][21][22][23] Consistently, the most common organisms causing postoperative endophthalmitis reported in DM patients were coagulase-negative Staphylococcus and gram-negative bacteria, which correlates with conjunctival ora of the DM. 13,18,24 The culture method is the gold standard for detecting microorganisms.…”

“…This high-throughput method can generate a million reads per run, thus reducing the cost and analytic time. [26][27][28] Many studies have reported the changes in the ocular surface microbiome in DM using the culture technique [19][20][21][22][23] , but only a few applied the NGS method. [29][30][31][32] To our knowledge, there is no previous report using the NGS method to study the ocular surface microbiome in DM according to the DR staging and glycemic control.…”

Pseudomonas aeruginosa Scleritis following Pterygium Surgery with Mitomycin C or Beta Irradiation: Three-Case Report

“…These findings may reflect that age could be one of the risk factors for Pseudomonas aeruginosa scleritis or the nature of a certain latency period after pterygium excision. Pseudomonas aeruginosa was detected in diabetic subjects more predominantly than nondiabetic subjects, demonstrated by the study of Noche et al [ 13 ]. One patient in our study also had diabetes that may be a risk factor for Pseudomonas aeruginosa scleritis.…”

Ocular surface microbiome in diabetes mellitus

“…These procedures may introduce the ocular surface microbes into the eye, resulting in intraocular infection 13,18 . The previous reports showed more bacterial colonization and the presence of gram-negative bacteria on the ocular surface of the DM than in the non-DM groups [19][20][21][22][23] . Consistently, the most common organisms causing postoperative endophthalmitis reported in DM patients were coagulase-negative Staphylococcus and gram-negative bacteria, which correlates with conjunctival flora of the DM 13,18,24 .The culture method is the gold standard for detecting microorganisms.…”