Vol 5 (2020): Continuous Publishing
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Published online: 2020-09-18

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Microbiology of the conjunctival sac before and after cataract surgery

Patrycja Kuklo1, Andrzej Grzybowski1
Ophthalmol J 2020;5:71-75.

Abstract

Background: The aim of the study was to evaluate the bacterial flora and antibiotic susceptibility profile of bacterial
isolates taken from the conjunctival sacs of patients undergoing phacoemulsification cataract surgery, and to compare them.

Material and methods: In total, 200 conjunctival swabs were collected from 50 patients between June and December of 2017.

Results: The most common pathogen collected from the conjunctival sacs before surgery was coagulase-negative staphylococci (CoNS) (65% of swabs); 45 of them (45%) were methicillin-sensitive staphylococci (MS-CoNS) and 25 (25%) were methicillin-resistant staphylococcus (MR-CoNS). Following the surgeries, CoNS were collected from 34 swabs (34%), 16% of which were taken from the eye on which the operation had been performed. Twenty-three swabs (23%) were MS-CoNS and 11 (11%) were MR-CoNS. The number of CoNS-positive swabs after pharmacotherapy decreased by 52%. The possibility of obtaining sterile swabs was statistically and significantly higher in eyes in which chemoprophylaxis was used [(OR = 4.58, 95% CI: 2.91–7.21), p < 0.001)]. The possibility of obtaining sterile swabs was not correlated with gender (p = 0.866) or diabetes (p = 0.712), but was observed more frequently in younger patients (p = 0.001). Multi-drug resistant bacteria were detected in 34 swabs before surgery (34%) and in 26 samples after operations (26%).

Conclusions: It is probably impossible to sterilise the conjunctival sac. There is a risk of multi-drug resistant bacterial flora colonising the conjunctival sac.

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References

  1. Taban M, Behrens A, Newcomb RL, et al. Acute endophthalmitis following cataract surgery: a systematic review of the literature. Arch Ophthalmol. 2005; 123(5): 613–620.
  2. Bannerman TL, Rhoden DL, McAllister SK, et al. The source of coagulase-negative staphylococci in the Endophthalmitis Vitrectomy Study. A comparison of eyelid and intraocular isolates using pulsed-field gel electrophoresis. Arch Ophthalmol. 1997; 115(3): 357–361.
  3. Leong J, Shah R, McCluskey P, et al. Bacterial contamination of the anterior chamber during phacoemulsification cataract surgery. J Cataract Refract Surg. 2002; 28(5): 826–833.
  4. Keynan Y, Finkelman Y, Lagacé-Wiens P. The microbiology of endophthalmitis: global trends and a local perspective. Eur J Clin Microbiol Infect Dis. 2012; 31(11): 2879–2886.
  5. HAN D, WISNIEWSKI S, WILSON L, et al. Spectrum and Susceptibilities of Microbiologic Isolates in the Endophthalmitis Vitrectomy Study. Am J Ophthalmol. 1996; 122(1): 1–17.
  6. Results of the Endophthalmitis Vitrectomy Study. Arch Ophthalmol. 1995; 113(12): 1479.
  7. Hori Y, Nakazawa T, Maeda N, et al. Susceptibility comparisons of normal preoperative conjunctival bacteria to fluoroquinolones. J Cataract Refract Surg. 2009; 35(3): 475–479.
  8. Simunovic MP, Rush RB, Hunyor AP, et al. Endophthalmitis following intravitreal injection versus endophthalmitis following cataract surgery: clinical features, causative organisms and post-treatment outcomes. Br J Ophthalmol. 2012; 96(6): 862–866.
  9. Fernández-Rubio ME, Rebolledo-Lara L, Martinez-García M, et al. The conjunctival bacterial pattern of diabetics undergoing cataract surgery. Eye (Lond). 2010; 24(5): 825–834.
  10. Hoshi S, Hashida M, Urabe K. Risk factors for aerobic bacterial conjunctival flora in preoperative cataract patients. Eye (Lond). 2016; 30(11): 1439–1446.
  11. Rubio EF. Climatic influence on conjunctival bacteria of patients undergoing cataract surgery. Eye (Lond). 2004; 18(8): 778–784.
  12. Hoshi S, Hashida M, Urabe K. Risk factors for aerobic bacterial conjunctival flora in preoperative cataract patients. Eye (Lond). 2016; 30(11): 1439–1446.
  13. Donnenfeld ED, Comstock TL, Proksch JW. Human aqueous humor concentrations of besifloxacin, moxifloxacin, and gatifloxacin after topical ocular application. J Cataract Refract Surg. 2011; 37(6): 1082–1089.
  14. Kıvanç SA, Kıvanç M, Bayramlar H. Microbiology of corneal wounds after cataract surgery: biofilm formation and antibiotic resistance patterns. J Wound Care. 2016; 25(1): 12, 14–9.