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Ekici Gok Z, Gunduz A, Bozgül PG. Evaluation of the effects of mono or combined use of topical antiglaucomatous drops on conjunctival flora and antibiotic susceptibility. Eur J Ophthalmol 2024; 34:1095-1101. [PMID: 38087444 DOI: 10.1177/11206721231219275] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/02/2024]
Abstract
PURPOSE To evaluate the effects of mono or combined use of topical antiglaucomatous drops (AGD) on conjunctival flora and antibiotic susceptibility. METHODS The study group consisting of 84 glaucoma patients using AGDs and 32 healthy controls were evaluated. Groups were formed according to the use of 1, 2 and 3 AGDs. A swab was taken from the conjunctival sac from each patient and cultures were made. Patients with conjunctival hyperemia were classified according to their appearance. RESULTS The mean age was 58.61 ± 14.55 years. Conjunctival culture positivity was 84.37%, 89.28% and 90.6% according to the use of 1, 2, and 3 AGDs, respectively, and it was 93.75% in the control group. Staphylococcus hominis (S. hominis) was statistically significantly higher in all glaucoma patients compared to healthy volunteers (p = .030). S. hominis was significantly higher especially in those using 2 (42.85%) and 3 (50%) AGDs, compared to those who received mono treatment (31.25%). Candida spp. was also significantly higher in glaucoma patients (p = .039). In patients with conjunctival hyperemia in glaucoma patients, the most common two bacteria were S. hominis (55.5%) and Staphylococcus epidermidis (S. epidermidis) (33%), respectively. In the relationship between isolated bacterial species and conjunctival hyperemia grades, Bacillus spp. (p = .013) was statistically significant.In glaucoma patients, norfloxacin and erythromycin resistance were found to be statistically significantly higher compared to the control group (p = .01). CONCLUSION Considering the statistically significant increase in isolates in all glaucoma patients, we suggest that more care should be taken in terms of infection in surgical procedures planned for glaucoma patients.
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Affiliation(s)
- Zarife Ekici Gok
- Department of Ophtalmology, Malatya Training and Research Hospital, Malatya, Turkey
| | - Ayten Gunduz
- Department of Microbiology, Malatya Training and Research Hospital, Malatya, Turkey
| | - Penpe Gül Bozgül
- Department of Ophtalmology, Malatya Inonu University School of Medicine, Malatya, Turkey
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2
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Caruso L, Fields M, Rimondi E, Zauli G, Longo G, Marcuzzi A, Previati M, Gonelli A, Zauli E, Milani D. Classical and Innovative Evidence for Therapeutic Strategies in Retinal Dysfunctions. Int J Mol Sci 2024; 25:2124. [PMID: 38396799 PMCID: PMC10889839 DOI: 10.3390/ijms25042124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 02/05/2024] [Accepted: 02/07/2024] [Indexed: 02/25/2024] Open
Abstract
The human retina is a complex anatomical structure that has no regenerative capacity. The pathogenesis of most retinopathies can be attributed to inflammation, with the activation of the inflammasome protein platform, and to the impact of oxidative stress on the regulation of apoptosis and autophagy/mitophagy in retinal cells. In recent years, new therapeutic approaches to treat retinopathies have been investigated. Experimental data suggest that the secretome of mesenchymal cells could reduce oxidative stress, autophagy, and the apoptosis of retinal cells, and in turn, the secretome of the latter could induce changes in mesenchymal cells. Other studies have evidenced that noncoding (nc)RNAs might be new targets for retinopathy treatment and novel disease biomarkers since a correlation has been found between ncRNA levels and retinopathies. A new field to explore is the interaction observed between the ocular and intestinal microbiota; indeed, recent findings have shown that the alteration of gut microbiota seems to be linked to ocular diseases, suggesting a gut-eye axis. To explore new therapeutical strategies for retinopathies, it is important to use proper models that can mimic the complexity of the retina. In this context, retinal organoids represent a good model for the study of the pathophysiology of the retina.
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Affiliation(s)
- Lorenzo Caruso
- Department of Environmental and Prevention Sciences, University of Ferrara, 44121 Ferrara, Italy; (L.C.); (A.G.)
| | - Matteo Fields
- Department of Translational Medicine, University of Ferrara, 44121 Ferrara, Italy; (M.F.); (G.L.); (A.M.); (M.P.); (D.M.)
| | - Erika Rimondi
- Department of Translational Medicine and LTTA Centre, University of Ferrara, 44121 Ferrara, Italy
| | - Giorgio Zauli
- Research Department, King Khaled Eye Specialist Hospital, Riyadh 11462, Saudi Arabia;
| | - Giovanna Longo
- Department of Translational Medicine, University of Ferrara, 44121 Ferrara, Italy; (M.F.); (G.L.); (A.M.); (M.P.); (D.M.)
| | - Annalisa Marcuzzi
- Department of Translational Medicine, University of Ferrara, 44121 Ferrara, Italy; (M.F.); (G.L.); (A.M.); (M.P.); (D.M.)
| | - Maurizio Previati
- Department of Translational Medicine, University of Ferrara, 44121 Ferrara, Italy; (M.F.); (G.L.); (A.M.); (M.P.); (D.M.)
| | - Arianna Gonelli
- Department of Environmental and Prevention Sciences, University of Ferrara, 44121 Ferrara, Italy; (L.C.); (A.G.)
| | - Enrico Zauli
- Department of Translational Medicine, University of Ferrara, 44121 Ferrara, Italy; (M.F.); (G.L.); (A.M.); (M.P.); (D.M.)
| | - Daniela Milani
- Department of Translational Medicine, University of Ferrara, 44121 Ferrara, Italy; (M.F.); (G.L.); (A.M.); (M.P.); (D.M.)
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Campagnoli LIM, Varesi A, Barbieri A, Marchesi N, Pascale A. Targeting the Gut-Eye Axis: An Emerging Strategy to Face Ocular Diseases. Int J Mol Sci 2023; 24:13338. [PMID: 37686143 PMCID: PMC10488056 DOI: 10.3390/ijms241713338] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 08/20/2023] [Accepted: 08/26/2023] [Indexed: 09/10/2023] Open
Abstract
The human microbiota refers to a large variety of microorganisms (bacteria, viruses, and fungi) that live in different human body sites, including the gut, oral cavity, skin, and eyes. In particular, the presence of an ocular surface microbiota with a crucial role in maintaining ocular surface homeostasis by preventing colonization from pathogen species has been recently demonstrated. Moreover, recent studies underline a potential association between gut microbiota (GM) and ocular health. In this respect, some evidence supports the existence of a gut-eye axis involved in the pathogenesis of several ocular diseases, including age-related macular degeneration, uveitis, diabetic retinopathy, dry eye, and glaucoma. Therefore, understanding the link between the GM and these ocular disorders might be useful for the development of new therapeutic approaches, such as probiotics, prebiotics, symbiotics, or faecal microbiota transplantation through which the GM could be modulated, thus allowing better management of these diseases.
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Affiliation(s)
| | - Angelica Varesi
- Department of Biology and Biotechnology, University of Pavia, 27100 Pavia, Italy;
| | - Annalisa Barbieri
- Department of Drug Sciences, Unit of Pharmacology, University of Pavia, 27100 Pavia, Italy; (A.B.); (N.M.)
| | - Nicoletta Marchesi
- Department of Drug Sciences, Unit of Pharmacology, University of Pavia, 27100 Pavia, Italy; (A.B.); (N.M.)
| | - Alessia Pascale
- Department of Drug Sciences, Unit of Pharmacology, University of Pavia, 27100 Pavia, Italy; (A.B.); (N.M.)
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4
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Astley RA, Mursalin MH, Coburn PS, Livingston ET, Nightengale JW, Bagaruka E, Hunt JJ, Callegan MC. Ocular Bacterial Infections: A Ten-Year Survey and Review of Causative Organisms Based on the Oklahoma Experience. Microorganisms 2023; 11:1802. [PMID: 37512974 PMCID: PMC10386592 DOI: 10.3390/microorganisms11071802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 06/29/2023] [Accepted: 07/10/2023] [Indexed: 07/30/2023] Open
Abstract
Ocular infections can be medical emergencies that result in permanent visual impairment or blindness and loss of quality of life. Bacteria are a major cause of ocular infections. Effective treatment of ocular infections requires knowledge of which bacteria are the likely cause of the infection. This survey of ocular bacterial isolates and review of ocular pathogens is based on a survey of a collection of isolates banked over a ten-year span at the Dean McGee Eye Institute in Oklahoma. These findings illustrate the diversity of bacteria isolated from the eye, ranging from common species to rare and unique species. At all sampled sites, staphylococci were the predominant bacteria isolated. Pseudomonads were the most common Gram-negative bacterial isolate, except in vitreous, where Serratia was the most common Gram-negative bacterial isolate. Here, we discuss the range of ocular infections that these species have been documented to cause and treatment options for these infections. Although a highly diverse spectrum of species has been isolated from the eye, the majority of infections are caused by Gram-positive species, and in most infections, empiric treatments are effective.
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Affiliation(s)
- Roger A Astley
- Department of Ophthalmology, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
| | - Md Huzzatul Mursalin
- Department of Ophthalmology, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
| | - Phillip S Coburn
- Department of Ophthalmology, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
| | - Erin T Livingston
- Department of Microbiology and Immunology, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
| | - James W Nightengale
- Department of Ophthalmology, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
| | - Eddy Bagaruka
- Department of Biology, Oklahoma Christian University, Edmond, OK 73013, USA
| | - Jonathan J Hunt
- Department of Biology, Oklahoma Christian University, Edmond, OK 73013, USA
| | - Michelle C Callegan
- Department of Ophthalmology, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
- Department of Microbiology and Immunology, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
- Dean McGee Eye Institute, Oklahoma City, OK 73104, USA
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5
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Chagas TA, Dos Reis MA, Leivas G, Santos LP, Gossenheimer AN, Melo GB, Malerbi FK, Schaan BD. Prevalence of diabetic retinopathy in Brazil: a systematic review with meta-analysis. Diabetol Metab Syndr 2023; 15:34. [PMID: 36864478 PMCID: PMC9979496 DOI: 10.1186/s13098-023-01003-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 02/19/2023] [Indexed: 03/04/2023] Open
Abstract
AIMS To evaluate the prevalence of diabetic retinopathy (DR) in Brazilian adults with diabetes mellitus via a systematic review with meta-analysis. METHODS A systematic review using PubMed, EMBASE, and Lilacs was conducted, searching for studies published up to February 2022. Random effect meta-analysis was performed to estimate the DR prevalence. RESULTS We included 72 studies (n = 29,527 individuals). Among individuals with diabetes in Brazil, DR prevalence was 36.28% (95% CI 32.66-39.97, I2 98%). Diabetic retinopathy prevalence was highest in patients with longer duration of diabetes and in patients from Southern Brazil. CONCLUSION This review shows a similar prevalence of DR as compared to other low- and middle-income countries. However, the high heterogeneity observed-expected in systematic reviews of prevalence-raises concerns about the interpretation of these results, suggesting the need for multicenter studies with representative samples and standardized methodology.
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Affiliation(s)
| | - Mateus Augusto Dos Reis
- Graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
| | - Gabriel Leivas
- Graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Lucas Porto Santos
- National Institute of Science and Technology for Health Technology Assessment (IATS), Porto Alegre, RS, Brazil
| | - Agnes Nogueira Gossenheimer
- Graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Gustavo Barreto Melo
- Department of Ophthalmology and Visual Science, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Fernando Korn Malerbi
- Department of Ophthalmology and Visual Science, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Beatriz D Schaan
- Graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
- National Institute of Science and Technology for Health Technology Assessment (IATS), Porto Alegre, RS, Brazil
- Endocrine Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
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Suwajanakorn O, Puangsricharern V, Kittipibul T, Chatsuwan T. Ocular surface microbiome in diabetes mellitus. Sci Rep 2022; 12:21527. [PMID: 36513692 PMCID: PMC9747965 DOI: 10.1038/s41598-022-25722-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 12/05/2022] [Indexed: 12/15/2022] Open
Abstract
This cross-sectional, age- and gender-matched study included 20 eyes of non-diabetic subjects (non-DM group) and 60 eyes of type 2 diabetes mellitus (DM group). Subgroups of DM were classified by diabetic retinopathy (DR) staging into no DR (DM-no DR), non-proliferative DR (DM-NPDR), proliferative DR (DM-PDR), and by glycemic control (well-controlled DM; HbA1c < 7%, poorly controlled DM; HbA1c ≥ 7%). Conjunctival swabs were performed for ocular surface microbiome analysis using conventional culture and next-generation sequencing analysis (NGS). A higher culture-positive rate was found in DM (15%) than in non-DM group (5%) (p value = 0.437). Pathogenic organisms and antibiotic-resistant strains were detected in the DR groups (DM-NPDR and DM-PDR). The NGS analysis showed that potentially pathogenic bacteria such as Enterobacteriaceae, Neisseriaceae, Escherichia-Shigella, and Pseudomonas predominated in DM, especially in DR. There was dissimilarity in the ocular surface microbiome between DM and non-DM groups. The subgroup analysis showed that the DR group had significantly different microbial community from DM-no DR and non-DM groups (p value < 0.05). The microbial community in the poorly controlled DM was also significantly different from well-controlled DM and non-DM groups (p < 0.001). Using the NGS method, our study is the first to signify the importance of DR and glycemic control status, which affect the changes in the ocular surface microbiome.
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Affiliation(s)
- Orathai Suwajanakorn
- grid.7922.e0000 0001 0244 7875Cornea and Refractive Surgery Unit, Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand ,grid.411628.80000 0000 9758 8584Excellence Center of Cornea and Limbal Stem Cell Transplantation, Department of Ophthalmology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Vilavun Puangsricharern
- grid.7922.e0000 0001 0244 7875Cornea and Refractive Surgery Unit, Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand ,grid.411628.80000 0000 9758 8584Excellence Center of Cornea and Limbal Stem Cell Transplantation, Department of Ophthalmology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Thanachaporn Kittipibul
- grid.7922.e0000 0001 0244 7875Cornea and Refractive Surgery Unit, Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand ,grid.411628.80000 0000 9758 8584Excellence Center of Cornea and Limbal Stem Cell Transplantation, Department of Ophthalmology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Tanittha Chatsuwan
- grid.7922.e0000 0001 0244 7875Department of Microbiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand ,grid.7922.e0000 0001 0244 7875Center of Excellence in Antimicrobial Resistance and Stewardship, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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7
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Tong L, Constancias F, Hou A, Chua SL, Drautz-Moses DI, Schuster SC, Yang L, Williams RBH, Kjelleberg S. Shotgun metagenomic sequencing analysis of ocular surface microbiome in Singapore residents with mild dry eye. Front Med (Lausanne) 2022; 9:1034131. [PMID: 36438051 PMCID: PMC9684611 DOI: 10.3389/fmed.2022.1034131] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 10/24/2022] [Indexed: 07/30/2023] Open
Abstract
The ocular surface microbiome has implications for ocular surface inflammation and immunology. Previous shotgun metagenomics analyses were performed in China, showing results that differed according to environment and age. Patients with Sjogren's syndrome were reported to have altered conjunctival microbiome, but such studies have not been done in milder dry eye. The aim of this study is to describe the conjunctival microbiome in people with mild dry eye in Singapore. Samples were collected from 14 participants with mild dry eye and 10 age-matched comparison participants recruited from Singapore National Eye Centre (SNEC) clinics. Shotgun metagenomic sequencing analysis was employed to evaluate the conjunctival microbiome composition. Proteobacteria formed the predominant phylum in the conjunctiva. As in a study from a coastal city in China, Achromobacter spp. was numerically most abundant. Compared to age-matched controls, the conjunctival microbial composition in mild dry eye was similar. Several microorganisms, including Streptococcus spp. increased in representation with age, and the abundance of Staphylococcus correlated with Schirmer readings. In addition, when cultured corneal epithelial cells were exposed to three strains of Achromobacter xylosoxidans, cytokines such as TNF-α and IL-6 were upregulated in the cell lysates and supernatants. Ourresults suggest that age is an important factor that affects composition of the conjunctival microbiome, and relative abundance of specific microorganism may vary according to the environment of the human host.
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Affiliation(s)
- Louis Tong
- Ocular Surface Research Group, Singapore Eye Research Institute, Singapore, Singapore
- Corneal and External Eye Disease Service, Singapore National Eye Centre, Singapore, Singapore
- Eye-Academic Clinical Programme, Office of Clinical, Academic and Faculty Affairs, Duke-NUS Medical School, Singapore, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Florentin Constancias
- Singapore Centre for Environmental Life Sciences Engineering (SCELSE), Nanyang Technological University, Singapore, Singapore
| | - Aihua Hou
- Ocular Surface Research Group, Singapore Eye Research Institute, Singapore, Singapore
- Eye-Academic Clinical Programme, Office of Clinical, Academic and Faculty Affairs, Duke-NUS Medical School, Singapore, Singapore
| | - Song Lin Chua
- Lee Kong Chian School of Medicine (LKCMedicine), Nanyang Technological University, Singapore, Singapore
| | - Daniela I. Drautz-Moses
- Singapore Centre for Environmental Life Sciences Engineering (SCELSE), Nanyang Technological University, Singapore, Singapore
| | - Stephan Christoph Schuster
- Singapore Centre for Environmental Life Sciences Engineering (SCELSE), Nanyang Technological University, Singapore, Singapore
- School of Biological Sciences, Nanyang Technological University, Singapore, Singapore
| | - Liang Yang
- Singapore Centre for Environmental Life Sciences Engineering (SCELSE), Nanyang Technological University, Singapore, Singapore
- School of Medicine, Southern University of Science and Technology, Shenzhen, China
| | - Rohan B. H. Williams
- Singapore Centre for Environmental Life Sciences Engineering (SCELSE), Nanyang Technological University, Singapore, Singapore
- Life Sciences Institute, National University of Singapore, Singapore, Singapore
| | - Staffan Kjelleberg
- Singapore Centre for Environmental Life Sciences Engineering (SCELSE), Nanyang Technological University, Singapore, Singapore
- School of Biological Sciences, Nanyang Technological University, Singapore, Singapore
- Centre for Marine Science and Innovation, School of Biological Earth and Environmental Sciences, University of New South Wales, Kensington, NSW, Australia
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8
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Wang Z, Zhang P, Huang C, Guo Y, Dong X, Li X. Conjunctival sac bacterial culture of patients using levofloxacin eye drops before cataract surgery: a real-world, retrospective study. BMC Ophthalmol 2022; 22:328. [PMID: 35907940 PMCID: PMC9338605 DOI: 10.1186/s12886-022-02544-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 07/20/2022] [Indexed: 11/21/2022] Open
Abstract
Background The use of antibiotics preoperatively is effective to decrease the incidence of ocular bacterial infections but may lead to high resistance rate, especially on patients with multi-risk clinical factors. This study systematically analyzed real-world data (RWD) of patients to reveal the association between clinical factors and conjunctival sac bacterial load and offer prophylaxis suggestions. Methods We retrieved RWD of patients using levofloxacin eye drops (5 mL: 24.4 mg, 4 times a day for 3 days) preoperatively. Retrieved data included information on the conjunctival sac bacterial culture, sex, presence of hypertension and diabetes mellitus (DM), and history of hospital-based surgeries. Data was analyzed using SPSS 24.0. Results RWD of 15,415 cases (patients) were retrieved. Among these patients, 5,866 (38.1%) were males and 9,549 (61.9%) females. 5,960 (38.7%) patients had a history of hypertension, and 3,493 (22.7%) patients had a history of DM. 7,555 (49.0%) patients had a history of hospital-based operations. There were 274 (1.8%) positive bacterial cultures. Male patients with hypertension and DM may be at increased risk of having positive bacterial cultures (P < 0.05). Staphylococcus epidermidis (n = 56, 20.4%), Kocuria rosea (n = 37, 13.5%), and Micrococcus luteus (n = 32, 11.7%) were the top 3 isolated strains. Most bacterial strains were resistant to various antibiotics except rifampin, and 82.5% (33 of 40 isolates) of Staphylococcus epidermidis isolates had multidrug antibiotic resistance. Numbers of culture-positive Staphylococcus epidermidis isolates in the male group and non-DM group were greater than those in the female and DM groups, respectively. Micrococcus luteus (n = 11, 8.8%) was found less frequently in non-hypertension group than in hypertension group. Conclusion Sex (Male) and the presence of hypertension and DM are risk factors for greater conjunctival sac bacterial loads. We offer a prophylactic suggestion based on the combined use of levofloxacin and rifampin. However, this approach may aggravate risk of multidrug resistance.
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Affiliation(s)
- Zhenyu Wang
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China.,Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China
| | - Pei Zhang
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China.,Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China
| | - Chen Huang
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China.,Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China.,Medical Research Center, Peking University Third Hospital, Beijing, China
| | - Yining Guo
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China.,Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China
| | - Xuhe Dong
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China.,Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China
| | - Xuemin Li
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China. .,Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China.
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9
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Xu S, Zhang H. Bacteriological profile of conjunctiva bacterial Flora in Northeast China: a hospital-based study. BMC Ophthalmol 2022; 22:223. [PMID: 35578220 PMCID: PMC9109342 DOI: 10.1186/s12886-022-02441-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 05/03/2022] [Indexed: 11/10/2022] Open
Abstract
PURPOSE To investigate the distribution and influencing factors of preoperative conjunctival flora from patients undergoing penetrating ocular surgeries in northeast China. METHODS An observational and cross-sectional study design was used. In 305 eyes of 305 patients without infective eye diseases who underwent ocular surgeries at the First Affiliated Hospital of Harbin Medical University between May 2018 and May 2019, conjunctival sac scrapings were collected on the day before surgery. RESULTS The mean age of the participants was 60.73 ± 14.23 years, with the majority being female, married and unemployed with at least primary school education. The positive culture rate was 48.20% (147/305 eyes), and 191 bacterial strains were isolated; two or more strains were isolated from 22.45% (33/147) of positive samples. The most commonly isolated bacteria was Staphylococcus epidermidis (64.92%), surpassing Staphylococcus aureus (5.76%). The culture positive rate of the young (18-40 years) group was different between the females (26.67%) and males (69.23%) (P = 0.024), but in the middle-aged group and the elderly group, the rates between the sexes were similar, with an increasing trend. Patients who visited in summer or autumn presented a higher positive rate than other seasons. Hypertensive women had a higher rate than hypertensive men (58.14% vs. 40%, χ2 = 5.8662, P = 0.0154). CONCLUSIONS In northeastern China, coagulase-negative Staphylococcus were the most common preoperative conjunctival bacteria. Hypertensive female patients, elderly patients, or those operated on in the summer and autumn should pay more attention to perioperative treatment. TRIAL REGISTRATION ChiCTR2100044659 .
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Affiliation(s)
- Shuo Xu
- Department of Ophthalmology, The Affiliated Wuxi No. 2 People's Hospital of Nanjing Medical University, WuXi, Jiangsu Province, People's Republic of China
| | - Hong Zhang
- Eye Hospital, The First Affiliated Hospital of Harbin Medical University, Harbin, 150000, Heilongjiang Province, People's Republic of China.
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10
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Singh RB, Das S, Chodosh J, Sharma N, Zegans ME, Kowalski RP, Jhanji V. Paradox of complex diversity: Challenges in the diagnosis and management of bacterial keratitis. Prog Retin Eye Res 2021; 88:101028. [PMID: 34813978 DOI: 10.1016/j.preteyeres.2021.101028] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 11/09/2021] [Accepted: 11/12/2021] [Indexed: 12/12/2022]
Abstract
Bacterial keratitis continues to be one of the leading causes of corneal blindness in the developed as well as the developing world, despite swift progress since the dawn of the "anti-biotic era". Although, we are expeditiously developing our understanding about the different causative organisms and associated pathology leading to keratitis, extensive gaps in knowledge continue to dampen the efforts for early and accurate diagnosis, and management in these patients, resulting in poor clinical outcomes. The ability of the causative bacteria to subdue the therapeutic challenge stems from their large genome encoding complex regulatory networks, variety of unique virulence factors, and rapid secretion of tissue damaging proteases and toxins. In this review article, we have provided an overview of the established classical diagnostic techniques and therapeutics for keratitis caused by various bacteria. We have extensively reported our recent in-roads through novel tools for accurate diagnosis of mono- and poly-bacterial corneal infections. Furthermore, we outlined the recent progress by our group and others in understanding the sub-cellular genomic changes that lead to antibiotic resistance in these organisms. Finally, we discussed in detail, the novel therapies and drug delivery systems in development for the efficacious management of bacterial keratitis.
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Affiliation(s)
- Rohan Bir Singh
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA; Department of Ophthalmology, Leiden University Medical Center, 2333, ZA Leiden, the Netherlands
| | - Sujata Das
- Cornea and Anterior Segment Services, LV Prasad Eye Institute, Bhubaneshwar, India
| | - James Chodosh
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Namrata Sharma
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Michael E Zegans
- Department of Ophthalmology, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Regis P Kowalski
- Department of Ophthalmology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA; The Charles T Campbell Ophthalmic Microbiology Laboratory, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Vishal Jhanji
- Department of Ophthalmology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA; The Charles T Campbell Ophthalmic Microbiology Laboratory, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
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11
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Zhu X, Wei L, Rong X, Zhang Y, Zhang Q, Wen X, He W, Zhang K, Chen F, Wei L, Lu Y. Conjunctival Microbiota in Patients With Type 2 Diabetes Mellitus and Influences of Perioperative Use of Topical Levofloxacin in Ocular Surgery. Front Med (Lausanne) 2021; 8:605639. [PMID: 33889581 PMCID: PMC8055849 DOI: 10.3389/fmed.2021.605639] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 03/09/2021] [Indexed: 01/14/2023] Open
Abstract
Background: Patients with type 2 diabetes mellitus (T2DM) are prone to ocular surface infections. We therefore characterized the conjunctival microbiome of T2DM patients and the influence of topical levofloxacin to investigate whether a dysbiosis is associated with this phenomenon. Methods: Conjunctival microbiome of 79 T2DM patients and 113 non-diabetic controls was profiled using the 16S rDNA sequencing approach. Furthermore, 21 T2DM and 14 non-diabetic patients who underwent cataract surgeries were followed up perioperatively and the influence of pre- and post-operative levofloxacin on the conjunctival microbiome was further investigated prospectively and compared longitudinally. Results: The α-diversity of the conjunctival microbiota was significantly higher in T2DM patients than in controls (P < 0.05). Significant differences in both composition and function of the conjunctival microbiome were identified on the ocular surface of T2DM patients as compared to non-diabetic controls. Particularly, phylum Bacteroidetes and Fusobacteria, genus Pseudomonas, Haemophilus, and Empedobacter were enriched, while genus Streptococcus was reduced on the T2DM ocular surface. Microbial genes functioning of bacterial chemotaxis was elevated in the conjunctival microbiome of T2DM patients. Furthermore, compared to the initial status, several genera including Staphylococcus were more abundant in the conjunctival microbiome of T2DM patients after 3-days use of preoperative levofloxacin topically, while no genus was more abundant in the non-diabetic follow-up group. No difference was observed between initial status and 7 days after ceasing all postoperative medications in both diabetic and non-diabetic follow-up groups. Conclusions: The conjunctival microbiome of T2DM patients was more complex and may respond differently to topical antibiotics.
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Affiliation(s)
- Xiangjia Zhu
- Department of Ophthalmology and Eye Institute, Ear, Nose and Throat (ENT) Hospital of Fudan University, Shanghai, China.,National Health Commission (NHC) Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Ling Wei
- Department of Ophthalmology and Eye Institute, Ear, Nose and Throat (ENT) Hospital of Fudan University, Shanghai, China.,National Health Commission (NHC) Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Xianfang Rong
- Department of Ophthalmology and Eye Institute, Ear, Nose and Throat (ENT) Hospital of Fudan University, Shanghai, China.,National Health Commission (NHC) Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Yinglei Zhang
- Department of Ophthalmology and Eye Institute, Ear, Nose and Throat (ENT) Hospital of Fudan University, Shanghai, China.,National Health Commission (NHC) Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Qian Zhang
- Central Laboratory, Peking University School and Hospital of Stomatology, Beijing, China
| | - Xiaofeng Wen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Wenwen He
- Department of Ophthalmology and Eye Institute, Ear, Nose and Throat (ENT) Hospital of Fudan University, Shanghai, China.,National Health Commission (NHC) Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Keke Zhang
- Department of Ophthalmology and Eye Institute, Ear, Nose and Throat (ENT) Hospital of Fudan University, Shanghai, China.,National Health Commission (NHC) Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Feng Chen
- Central Laboratory, Peking University School and Hospital of Stomatology, Beijing, China
| | - Lai Wei
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Yi Lu
- Department of Ophthalmology and Eye Institute, Ear, Nose and Throat (ENT) Hospital of Fudan University, Shanghai, China.,National Health Commission (NHC) Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
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12
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Aragona P, Baudouin C, Benitez Del Castillo JM, Messmer E, Barabino S, Merayo-Lloves J, Brignole-Baudouin F, Inferrera L, Rolando M, Mencucci R, Rescigno M, Bonini S, Labetoulle M. The ocular microbiome and microbiota and their effects on ocular surface pathophysiology and disorders. Surv Ophthalmol 2021; 66:907-925. [PMID: 33819460 DOI: 10.1016/j.survophthal.2021.03.010] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 03/25/2021] [Accepted: 03/26/2021] [Indexed: 12/17/2022]
Abstract
The ocular surface flora perform an important role in the defense mechanisms of the ocular surface system. Its regulation of the immunological activity and the barrier effect against pathogen invasion are remarkable. Composition of the flora differs according to the methods of investigation, because the microbiome, composed of the genetic material of bacteria, fungi, viruses, protozoa, and eukaryotes on the ocular surface, differs from the microbiota, which are the community of microorganisms that colonize the ocular surface. The observed composition of the ocular surface flora depends on harvesting and examining methods, whether with traditional culture or with more refined genetic analysis based on rRNA and DNA sequencing. Environment, diet, sex, and age influence the microbial flora composition, thus complicating the analysis of the baseline status. Moreover, potentially pathogenic organisms can affect its composition, as do various disorders, including chronic inflammation, and therapies applied to the ocular surface. A better understanding of the composition and function of microbial communities at the ocular surface could bring new insights and clarify the epidemiology and pathology of ocular surface dynamics in health and disease. The purpose of this review is to provide an up-to-date overview of knowledge about this topic.
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Affiliation(s)
- Pasquale Aragona
- Department of Biomedical Sciences, Ophthalmology Clinic, University of Messina, Messina, Italy.
| | - Christophe Baudouin
- Quinze-Vingts National Eye Hospital, IHU ForeSight, Paris Saclay University, Paris, France
| | - Jose M Benitez Del Castillo
- Departamento de Oftalmología, Hospital Clínico San Carlos, Clínica Rementeria, Instituto Investigaciones Oftalmologicas Ramon Castroviejo, Universidad Complutense, Madrid, Spain
| | - Elisabeth Messmer
- Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany
| | - Stefano Barabino
- Ocular Surface and Dry Eye Center, Ospedale L. Sacco, University of Milan, Milan, Italy
| | - Jesus Merayo-Lloves
- Instituto Universitario Fernández-Vega, Universidad de Oviedo, Oviedo, Spain
| | - Francoise Brignole-Baudouin
- Sorbonne Université, INSERM UMR_S968, CNRS UMR7210, Institut de la Vision, Paris, France; CHNO des Quinze-Vingts, INSERM-DGOS CIC 1423, Laboratoire de Biologie Médicale, Paris, France; Université de Paris, Faculté de Pharmacie de Paris, Département de Chimie-Toxicologie Analytique et Cellulaire, Paris, France
| | - Leandro Inferrera
- Department of Biomedical Sciences, Ophthalmology Clinic, University of Messina, Messina, Italy
| | - Maurizio Rolando
- Ocular Surface and Dry Eye Center, ISPRE Ophthalmics, Genoa, Italy
| | - Rita Mencucci
- Department of Neuroscience, Psychology, Pharmacology and Child Health (NEUROFARBA), Eye Clinic, University of Florence, Florence, Italy
| | - Maria Rescigno
- Humanitas Clinical and Research Center - IRCCS, Humanitas University Department of Biomedical Sciences, Milan, Italy
| | - Stefano Bonini
- Department of Ophthalmology, University of Rome Campus Biomedico, Rome, Italy
| | - Marc Labetoulle
- Ophthalmology Départment, Hôpitaux Universitaires Paris-Sud, APHP, Université Paris-Saclay, IDMIT Infrastructure, Fontenay-aux-Roses Cedex, France
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13
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Matysiak A, Kabza M, Karolak JA, Jaworska MM, Rydzanicz M, Ploski R, Szaflik JP, Gajecka M. Characterization of Ocular Surface Microbial Profiles Revealed Discrepancies between Conjunctival and Corneal Microbiota. Pathogens 2021; 10:pathogens10040405. [PMID: 33808469 PMCID: PMC8067172 DOI: 10.3390/pathogens10040405] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 03/19/2021] [Accepted: 03/25/2021] [Indexed: 12/12/2022] Open
Abstract
The ocular microbiome composition has only been partially characterized. Here, we used RNA-sequencing (RNA-Seq) data to assess microbial diversity in human corneal tissue. Additionally, conjunctival swab samples were examined to characterize ocular surface microbiota. Short RNA-Seq reads, obtained from a previous transcriptome study of 50 corneal tissues, were mapped to the human reference genome GRCh38 to remove sequences of human origin. The unmapped reads were then used for taxonomic classification by comparing them with known bacterial, archaeal, and viral sequences from public databases. The components of microbial communities were identified and characterized using both conventional microbiology and polymerase chain reaction (PCR) techniques in 36 conjunctival swabs. The majority of ocular samples examined by conventional and molecular techniques showed very similar microbial taxonomic profiles, with most of the microorganisms being classified into Proteobacteria, Firmicutes, and Actinobacteria phyla. Only 50% of conjunctival samples exhibited bacterial growth. The PCR detection provided a broader overview of positive results for conjunctival materials. The RNA-Seq assessment revealed significant variability of the corneal microbial communities, including fastidious bacteria and viruses. The use of the combined techniques allowed for a comprehensive characterization of the eye microbiome's elements, especially in aspects of microbiota diversity.
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Affiliation(s)
- Anna Matysiak
- Chair and Department of Genetics and Pharmaceutical Microbiology, Poznan University of Medical Sciences, 60-781 Poznan, Poland; (A.M.); (M.K.); (J.A.K.); (M.M.J.)
| | - Michal Kabza
- Chair and Department of Genetics and Pharmaceutical Microbiology, Poznan University of Medical Sciences, 60-781 Poznan, Poland; (A.M.); (M.K.); (J.A.K.); (M.M.J.)
| | - Justyna A. Karolak
- Chair and Department of Genetics and Pharmaceutical Microbiology, Poznan University of Medical Sciences, 60-781 Poznan, Poland; (A.M.); (M.K.); (J.A.K.); (M.M.J.)
- Institute of Human Genetics, Polish Academy of Sciences, 60-479 Poznan, Poland
| | - Marcelina M. Jaworska
- Chair and Department of Genetics and Pharmaceutical Microbiology, Poznan University of Medical Sciences, 60-781 Poznan, Poland; (A.M.); (M.K.); (J.A.K.); (M.M.J.)
| | - Malgorzata Rydzanicz
- Department of Medical Genetics, Medical University of Warsaw, 02-106 Warsaw, Poland; (M.R.); (R.P.)
| | - Rafal Ploski
- Department of Medical Genetics, Medical University of Warsaw, 02-106 Warsaw, Poland; (M.R.); (R.P.)
| | - Jacek P. Szaflik
- Department of Ophthalmology, Medical University of Warsaw, 00-576 Warsaw, Poland;
| | - Marzena Gajecka
- Chair and Department of Genetics and Pharmaceutical Microbiology, Poznan University of Medical Sciences, 60-781 Poznan, Poland; (A.M.); (M.K.); (J.A.K.); (M.M.J.)
- Institute of Human Genetics, Polish Academy of Sciences, 60-479 Poznan, Poland
- Correspondence:
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14
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Shah R, Amador C, Tormanen K, Ghiam S, Saghizadeh M, Arumugaswami V, Kumar A, Kramerov AA, Ljubimov AV. Systemic diseases and the cornea. Exp Eye Res 2021; 204:108455. [PMID: 33485845 PMCID: PMC7946758 DOI: 10.1016/j.exer.2021.108455] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 01/11/2021] [Accepted: 01/12/2021] [Indexed: 01/08/2023]
Abstract
There is a number of systemic diseases affecting the cornea. These include endocrine disorders (diabetes, Graves' disease, Addison's disease, hyperparathyroidism), infections with viruses (SARS-CoV-2, herpes simplex, varicella zoster, HTLV-1, Epstein-Barr virus) and bacteria (tuberculosis, syphilis and Pseudomonas aeruginosa), autoimmune and inflammatory diseases (rheumatoid arthritis, Sjögren's syndrome, lupus erythematosus, gout, atopic and vernal keratoconjunctivitis, multiple sclerosis, granulomatosis with polyangiitis, sarcoidosis, Cogan's syndrome, immunobullous diseases), corneal deposit disorders (Wilson's disease, cystinosis, Fabry disease, Meretoja's syndrome, mucopolysaccharidosis, hyperlipoproteinemia), and genetic disorders (aniridia, Ehlers-Danlos syndromes, Marfan syndrome). Corneal manifestations often provide an insight to underlying systemic diseases and can act as the first indicator of an undiagnosed systemic condition. Routine eye exams can bring attention to potentially life-threatening illnesses. In this review, we provide a fairly detailed overview of the pathologic changes in the cornea described in various systemic diseases and also discuss underlying molecular mechanisms, as well as current and emerging treatments.
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Affiliation(s)
- Ruchi Shah
- Eye Program, Board of Governors Regenerative Medicine Institute, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
| | - Cynthia Amador
- Eye Program, Board of Governors Regenerative Medicine Institute, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Kati Tormanen
- Center for Neurobiology and Vaccine Development, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Sean Ghiam
- Sackler School of Medicine, New York State/American Program of Tel Aviv University, Tel Aviv, Israel
| | - Mehrnoosh Saghizadeh
- Eye Program, Board of Governors Regenerative Medicine Institute, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Departments of Molecular and Medical Pharmacology, Medicine, and Eli and Edythe Broad Center of Regenerative Medicine and Stem Cell Research, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Vaithi Arumugaswami
- Departments of Molecular and Medical Pharmacology, Medicine, and Eli and Edythe Broad Center of Regenerative Medicine and Stem Cell Research, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Ashok Kumar
- Department of Ophthalmology, Visual and Anatomical Sciences, Wayne State University, Detroit, MI, USA
| | - Andrei A Kramerov
- Eye Program, Board of Governors Regenerative Medicine Institute, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Alexander V Ljubimov
- Eye Program, Board of Governors Regenerative Medicine Institute, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Departments of Molecular and Medical Pharmacology, Medicine, and Eli and Edythe Broad Center of Regenerative Medicine and Stem Cell Research, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
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15
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Simina DS, Larisa I, Otilia C, Ana Cristina G, Liliana MV, Aurelian MG. The ocular surface bacterial contamination and its management in the prophylaxis of post cataract surgery endophthalmitis. Rom J Ophthalmol 2021; 65:2-9. [PMID: 33817426 PMCID: PMC7995501 DOI: 10.22336/rjo.2021.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2021] [Indexed: 11/20/2022] Open
Abstract
Objective: To investigate the recent pieces of evidence regarding the bacterial ocular surface contamination and its treatment in the prophylaxis of post-cataract surgery endophthalmitis. Methods: We conducted a literature research on the topic of interest and selected the most relevant data. Results: The studies reported a relatively high rate of positive conjunctival culture and the most frequently isolated organism was Coagulase negative Staphylococcus, which is also the most common etiological agent of the postoperative endophthalmitis. The bacterial ocular surface load is influenced by age, climate, associated diseases, topical and systemic medication. The use of povidone-iodine alone or in association with levofloxacin eyedrops as prophylactic method is effective in reducing the conjunctival bacterial contamination and consequently decreases the incidence of postoperative endophthalmitis. Conclusions: Based on the current pieces of evidence, adequate treatment of the bacterial ocular surface contamination prior to cataract surgery seems to be effective in preventing endophthalmitis after cataract surgery. Abbreviations: EU = European Union, Spp. = Species, HIV = Human Immunodeficiency Virus.
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Affiliation(s)
| | - Ilie Larisa
- Department of Ophthalmology, University Emergency Hospital, Bucharest, Romania
| | - Costeliu Otilia
- Department of Ophthalmology, University Emergency Hospital, Bucharest, Romania
| | | | - Mary Voinea Liliana
- Department of Ophthalmology, University Emergency Hospital, Bucharest, Romania
| | - Mihai Ghiță Aurelian
- Department of Ophthalmology, University Emergency Hospital, Bucharest, Romania
- Ocularcare Eye Clinic, Bucharest, Romania
- Department of Physiology II, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
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16
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Kaldirim H, Yazgan S, Kirgiz A, Ozdemir B, Yilmaz A. Effect of Topical Antibiotic Prophylaxis on Conjunctival Flora and Antibiotic Resistance Following Intravitreal Injections in Patients with Type 2 Diabetes. KOREAN JOURNAL OF OPHTHALMOLOGY 2020; 34:265-273. [PMID: 32783418 PMCID: PMC7419237 DOI: 10.3341/kjo.2019.0144] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Revised: 02/16/2020] [Accepted: 03/17/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose We sought to determine changes in the conjunctival bacterial flora and antibiotic resistance after topical antibiotic drops for infection prophylaxis were administered following intravitreal injections in patients with type 2 diabetes. Methods This prospective and nonrandomized cohort study included 116 eyes of 116 treatment-naive patients with type 2 diabetes who received six serial intravitreal anti-vascular endothelial growth factor injections for macular edema. Three conjunctival cultures were obtained from each eye over the course of the study (Culture 1, baseline; Culture 2, 1 month after the third injection; and Culture 3, 1 month after the sixth injection). The study subjects were given topical moxifloxacin hydrochloride for 4 days after each monthly intravitreal injection. The growth patterns of conjunctival bacterial flora and the antibiotic resistance to several commonly used antibiotics were examined. Results The rate of culture positivity increased significantly during the observation period (Culture 1, n = 47, 40.5%; Culture 2, n = 58, 50%; Culture 3, n = 76, 65.5%, p < 0.001). The bacterium with the highest baseline culture positivity was Staphylococcus epidermidis (n = 45, 38.8%), which increased significantly during the observation period (p < 0.001). No significant increase was noted in the culture positivity of the other bacteria with baseline culture positivity (p > 0.05). Regarding antibiotic susceptibility, significant increases in resistance to the fluoroquinolone group of drugs were noted (p < 0.001). No significant changes in sensitivity were detected in the other 11 investigated antibiotics that are commonly used in clinical practice (p > 0.05). Conclusions The use of topical moxifloxacin after each intravitreal injection significantly increases the fluoroquinolone resistance of the ocular surface flora and the culture-positivity rate of S. epidermidis in patients with type 2 diabetes.
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Affiliation(s)
- Havva Kaldirim
- Department of Ophthalmology, Bagcilar Training and Research Hospital, Health Sciences University, Istanbul, Turkey.
| | - Serpil Yazgan
- Department of Ophthalmology, Medical Faculty, Inonu University, Malatya, Turkey
| | - Ahmet Kirgiz
- Department of Ophthalmology, Beyoglu Eye Training and Research Hospital, Health Sciences University, Istanbul, Turkey
| | - Bilge Ozdemir
- Department of Microbiology, Bagcilar Training and Research Hospital, Health Sciences University, Istanbul, Turkey
| | - Ahu Yilmaz
- Department of Ophthalmology, Bagcilar Training and Research Hospital, Health Sciences University, Istanbul, Turkey
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17
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Garza A, Diaz G, Hamdan M, Shetty A, Hong BY, Cervantes J. Homeostasis and Defense at the Surface of the Eye. The Conjunctival Microbiota. Curr Eye Res 2020; 46:1-6. [PMID: 32584612 DOI: 10.1080/02713683.2020.1788100] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The literature on ocular microbiome has grown tremendously over the past decade, and our knowledge of the different aspects and roles in homeostasis and protection is continuously growing. The development of 16 S rRNA sequencing has allowed the field to characterize communities of bacteria in health and ocular disease. Efforts should continue to further elucidate the interplay between microbiome and key players, such as age, comorbidities, and contact lens usage in order to have better control of the sight-threatening complications.
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Affiliation(s)
- Arnulfo Garza
- Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center , El Paso, TX, USA
| | - Giancarlo Diaz
- Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center , El Paso, TX, USA
| | - Marah Hamdan
- Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center , El Paso, TX, USA
| | - Akaanksh Shetty
- Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center , El Paso, TX, USA
| | - Bo-Young Hong
- The Jackson Laboratory for Genomic Medicine , Farmington, CT, USA
| | - Jorge Cervantes
- Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center , El Paso, TX, USA
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18
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Richdale K, Chao C, Hamilton M. Eye care providers' emerging roles in early detection of diabetes and management of diabetic changes to the ocular surface: a review. BMJ Open Diabetes Res Care 2020; 8:8/1/e001094. [PMID: 32299899 PMCID: PMC7199150 DOI: 10.1136/bmjdrc-2019-001094] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 03/20/2020] [Accepted: 03/24/2020] [Indexed: 12/16/2022] Open
Abstract
US adults visit eye care providers more often than primary healthcare providers, placing these doctors in a prime position to help identify and manage patients with prediabetes and diabetes. Currently, diabetes is identified in eye clinics in an advanced stage, only after visible signs of diabetic retinopathy. Recent ophthalmic research has identified multiple subclinical and clinical changes that occur in the anterior segment of the eye with metabolic disease. The corneal epithelium exhibits increased defects and poor healing, including an increased risk of neurotrophic keratitis. Increased thickness and stiffness of the cornea artificially alters intraocular pressure. There is damage to the endothelial cells and changes to the bacterial species on the ocular surface, both of which can increase risk of complications with surgery. Decreased corneal sensitivity due to a loss of nerve density predispose patients with metabolic disease to further neurotrophic complications. Patients with diabetes have increased Meibomian gland dysfunction, blepharitis and reduced tear production, resulting in increased rates of dry eye disease and discomfort. Early detection of metabolic disease may allow eye care providers to be more proactive in recommending referral and intervention in order to reduce the risk of blindness and other diabetes-related morbidity. Continued research is needed to better understand the time course of changes to the anterior segment and what can be done to better detect and diagnose patients with prediabetes or undiagnosed diabetes and provide improved care for these patients.
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Affiliation(s)
- Kathryn Richdale
- College of Optometry, University of Houston, Houston, Texas, USA
| | - Cecilia Chao
- College of Optometry, University of Houston, Houston, Texas, USA
- School of Optometry and Vision Science, University of New South Wales-Kensington Campus, Sydney, New South Wales, Australia
| | - Marc Hamilton
- Health and Human Performance, University of Houston, Houston, Texas, USA
- Biology and Biochemistry, University of Houston, Houston, Texas, USA
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19
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Kıvanç SA, Arık G, Akova-Budak B, Kıvanç M. Biofilm forming capacity and antibiotic susceptibility of Staphylococcus spp. with the icaA/icaD/bap genotype isolated from ocular surface of patients with diabetes. Malawi Med J 2019; 30:243-249. [PMID: 31798802 PMCID: PMC6863420 DOI: 10.4314/mmj.v30i4.6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Introduction Bacterial biofilm is an exopolysaccharide matrix that is produced by bacteria while they adhere on abiotic or biotic surfaces. The bacteria living in this matrix are more resistant to antibiotics than planctonic bacteria. The biofilm formation property of the bacteria is determined by genes; and this is related to virulence of the microorganism. In ophthalmology, biofilms form especially on abiotic surfaces such as silicon tubes, contact lenses, intraocular lenses etc. Aim Our aim was to investigate genotypic and phenotypic structures of biofilms that are produced by Staphylococcus spp., which was obtained from the eyes of diabetic patients and determine the effect on antibiotic susceptibility. Methods The study group was comprised with 83 isolates from diabetic patients and 21 isolates from non-diabetic patients. Presumptive isolates were detected and confirmed by a microbial identification system VITEK II. Automated EcoRI Ribotyping was performed. Biofilm production was detected by Congo Red Agar Plate and Microtiter Plate Assay. Disc diffusion method was used for determination of antibiotic susceptibility of isolates. Results Out of the 83 isolates from diabetic patients, 25 were weakly (30%), 20 were moderately (24%), and 25 were strongly (30%) biofilm positive. Seven isolates of S. aureus, 11 isolates of S.epidermidis, 2 isolates of S. warneri, 3 isolates of S.hominis, and 2 isolates of S.lugdunensis were identified as strong biofilm producers. Out of the 83 Staphylococcus isolates, 37 were cefuroxime, 18 ciprofloxacin, 11 vancomycin, 12 gatifloxacin, and 18 moxifloxacin resistant. In total, 37 strains were resistant to three or more antibiotics. There was a statistically significant relation between biofilm formation and multidrug resistance (against three or more antibiotics, p<0.001). In nondiabetic patients, 15(71%) isolates were non adherent or weakly adherent, and 2(10%) were strongly adherent biofilm positive. Conclusion In conclusion, bacterial conjunctival flora of patients with diabetes is likely to produce biofilm. Biofilm formation is associated with multidrug rsistance in patients with diabetes.
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Affiliation(s)
- Sertaç Argun Kıvanç
- Uludag University, School of Medicine, Department of Ophthalmology, Görükle, Bursa/Turkey
| | - Gizem Arık
- Anadolu University, Faculty of Science, Department of Microbiology, Eskişehir/Turkey
| | - Berna Akova-Budak
- Uludag University, School of Medicine, Department of Ophthalmology, Görükle, Bursa/Turkey
| | - Merih Kıvanç
- Anadolu University, Faculty of Science, Department of Microbiology, Eskişehir/Turkey
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20
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Li S, Yi G, Peng H, Li Z, Chen S, Zhong H, Chen Y, Wang Z, Deng Q, Fu M. How Ocular Surface Microbiota Debuts in Type 2 Diabetes Mellitus. Front Cell Infect Microbiol 2019; 9:202. [PMID: 31263683 PMCID: PMC6590198 DOI: 10.3389/fcimb.2019.00202] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Accepted: 05/23/2019] [Indexed: 12/20/2022] Open
Abstract
High glucose represents a good environment for bacterial growth on the skin, on the ocular surface (OS) and in the tears of type 2 diabetes mellitus (T2DM) patients, affecting the conjunctival bacterial community. This study aimed to investigate the OS bacterial flora of T2DM patients and healthy subjects using 16S rRNA sequencing-based bacterial identification. Among 23 healthy subjects (CON) and 31 T2DM patients, 54 eyes were examined to investigate the OS bacterial community. Factors potentially affecting the microbial growth were controlled. Results showed the OS microbiota presented higher diversity in the T2DM group than in the CON group. Bioinformatic analysis showed a lower abundance of Proteobacteria and a higher abundance of Bacteroidetes at the phyla level as well as a significantly increased abundance of Acinetobacter and Pseudomonas at the genus level in the T2DM group. The difference in OS microbiota at taxonomic level was associated with Ocular Surface Disease Index and course of T2DM. These findings indicate the OS flora in T2DM patients is significantly different from that in healthy subjects, which may be closely associated with OS discomfort and course of T2DM.
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Affiliation(s)
- Siqi Li
- Department of Ophthalmology, Zhujiang Hospital of Southern Medical University, Guangzhou, China
| | - Guoguo Yi
- Department of Ophthalmology, Zhujiang Hospital of Southern Medical University, Guangzhou, China
| | - Hui Peng
- School of Nursing, Hunan University of Medicine, Hunan, China
| | - Zhenhao Li
- Department of Ophthalmology, Zhujiang Hospital of Southern Medical University, Guangzhou, China
| | - Shuze Chen
- Department of Ophthalmology, Zhujiang Hospital of Southern Medical University, Guangzhou, China
| | - Huimin Zhong
- Department of Ophthalmology, Zhujiang Hospital of Southern Medical University, Guangzhou, China
| | - Yifan Chen
- Department of Ophthalmology, Zhujiang Hospital of Southern Medical University, Guangzhou, China
| | - Zhoucheng Wang
- Department of Ophthalmology, Zhujiang Hospital of Southern Medical University, Guangzhou, China
| | - Qixin Deng
- Department of Ophthalmology, Zhujiang Hospital of Southern Medical University, Guangzhou, China
| | - Min Fu
- Department of Ophthalmology, Zhujiang Hospital of Southern Medical University, Guangzhou, China
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Hu VH, Macleod D, Massae P, Afwamba I, Weiss HA, Mabey DCW, Bailey RL, Burton MJ. Non-Chlamydial Bacterial Infection and Progression of Conjunctival Scarring in Trachoma. Invest Ophthalmol Vis Sci 2019; 59:2339-2344. [PMID: 29847638 PMCID: PMC5939686 DOI: 10.1167/iovs.17-23381] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Purpose The purpose of this study was to assess whether non-chlamydial bacterial infection is associated with progression of trachomatous scarring in adults. Methods This was a cohort study involving 800 participants in northern Tanzania who underwent clinical examination, photography, and conjunctival swab collection for microbiology over a 24-month period. Samples for microbiology were inoculated onto blood and chocolate agar, and Chlamydia trachomatis was detected by PCR. Progression was determined by comparison of baseline to 24-month photographs. Results C. trachomatis was detected in only four participants at baseline. At 24 months, 617 participants (77.1%) were followed up. Of those seen at 24 months, 452 could be reliably assessed. Definite scarring progression (progressors) was seen in 345 (55.9%); there was no progression (nonprogressors) in 107 (17.3%). Using combined baseline and 12-month microbiology results, progressors had significantly higher levels of commensal and pathogenic bacterial organisms detected compared with nonprogressors. After adjusting for age, baseline scarring, and ethnicity, there was weak evidence (P = 0.07) that the bacteria category was associated with scarring progression (commensal organisms only: odds ratio [OR] = 1.61; 95% confidence interval [CI]: 0.90 to 2.89; pathogenic organisms either with or without commensal: OR = 2.39; 95% CI: 1.10 to 5.16). Conclusion The findings were consistent with the possibility that trachomatous scarring in adults is associated with the presence of non-chlamydial bacterial organisms, particularly pathogenic organisms. C. trachomatis was detected very infrequently and may not be an important factor in the pathogenesis of scarring progression in adults. This has implications for trachoma control programs, which largely concentrate on reducing C. trachomatis levels and transmission.
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Affiliation(s)
- Victor H Hu
- London School of Hygiene and Tropical Medicine, London, United Kingdom.,Kilimanjaro Christian Medical Centre, Moshi, Tanzania
| | - David Macleod
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | - Isaac Afwamba
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania
| | - Helen A Weiss
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - David C W Mabey
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Robin L Bailey
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Matthew J Burton
- London School of Hygiene and Tropical Medicine, London, United Kingdom.,Kilimanjaro Christian Medical Centre, Moshi, Tanzania
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Bussan KA, Robertson DM. Contact lens wear and the diabetic corneal epithelium: A happy or disastrous marriage? J Diabetes Complications 2019; 33:75-83. [PMID: 30391097 PMCID: PMC7364814 DOI: 10.1016/j.jdiacomp.2018.09.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 09/10/2018] [Accepted: 09/23/2018] [Indexed: 12/11/2022]
Abstract
Diabetes mellitus is an epidemic in the US and abroad. With the advent of new contact lens technology, the use of contact lenses as glucose sensors in lieu of the traditional finger stick is quickly becoming realized. This has the potential to rapidly expand the contact lens market into this growing patient population. The independent cellular and physiological effects of contact lens wear and diabetes on the corneal epithelium have been described. However, little evidence exists to date to support whether there is increased risk associated with contact lens wear in diabetes. The focus of this review is to discuss what is known about the cellular effects of contact lenses on the corneal epithelium, the pathophysiological changes in the corneal epithelium that occur in diabetes, and whether an increased risk for corneal epithelial damage and/or infection may negatively impact safety in diabetic contact lens wearers. Available data indicates that there are inherent risks associated with contact lens wear in diabetics. Importantly, eye care practitioners fitting contact lenses in the diabetic patient need to carefully consider the duration of disease, the level of glycemic control, the presence of retinopathy, and the patient's overall health.
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Affiliation(s)
- Katherine A Bussan
- The Department of Ophthalmology, The University of Texas Southwestern Medical Center, United States of America
| | - Danielle M Robertson
- The Department of Ophthalmology, The University of Texas Southwestern Medical Center, United States of America.
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23
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The impact of diabetes on corneal nerve morphology and ocular surface integrity. Ocul Surf 2018; 16:45-57. [DOI: 10.1016/j.jtos.2017.10.006] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Revised: 10/03/2017] [Accepted: 10/26/2017] [Indexed: 12/11/2022]
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Toribio A, Marrodán T, Fernández-Natal I, Martínez-Blanco H, Rodríguez-Aparicio L, Ferrero MÁ. Study of conjunctival flora in anophthalmic patients: influence on the comfort of the socket. Graefes Arch Clin Exp Ophthalmol 2017; 255:1669-1679. [PMID: 28601909 DOI: 10.1007/s00417-017-3708-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Revised: 05/08/2017] [Accepted: 05/30/2017] [Indexed: 12/01/2022] Open
Abstract
PURPOSE To investigate the relationship between conjunctival flora and comfort of the socket in anophthalmic patients. METHODS A cross-sectional clinical study including 60 patients with unilateral anophthalmia who wear a prosthetic eye. From each patient three microbiological samples were taken from the lower conjunctival sac (healthy eye, pre-prosthesis, and retro-prosthesis space of socket). The 180 samples obtained were cultured. Samples from a randomized subgroup of 29 patients were measured by spectrophotometry at 540 nm after 48 h of growth, to determine their microbial density (MD). The grade of comfort of the socket (GCS) of each patient was established by a questionnaire. Epidemiological and clinical data of the anophthalmic socket and artificial eye care of each patient were also collected. RESULTS MD decreased in healthy eyes (0.213 ± 0.201, P = 0.004) compared with the pre-prosthesis (0.402 ± 0.323) and retro-prosthesis (0.438 ± 0.268) samples. Pre-prosthesis MD correlated with retro-prosthesis MD (R = 0.401, P = 0.031) and healthy eye MD (R = 0.482, P = 0.008), and it was also related to poor GCS (P = 0.017). Aerobic Gram-negative bacteria in retro-prosthesis samples of patients with poor GCS was higher than in patients with good or fair GCS (P = 0.008). In the same samples, coagulase-negative staphylococci proportion (excluding S. epidermidis) increased in patients with good GCS (P = 0.030). CONCLUSIONS Socket microflora is related to GCS. Increased pathogenic flora, especially Gram-negative bacteria, and high MD are related to discomfort, while coagulase-negative staphylococci (other than S. epidermidis) are associated with comfort.
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Affiliation(s)
- Alvaro Toribio
- Department of Ophthalmology, University Hospital of León, Altos de Nava s/n, 24071, Leon, Spain.
| | - Teresa Marrodán
- Department of Clinical Microbiology, University Hospital of León, León, Spain
| | | | | | | | - Miguel Á Ferrero
- Department of Molecular Biology, University of León, León, Spain
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Diabetic complications in the cornea. Vision Res 2017; 139:138-152. [PMID: 28404521 DOI: 10.1016/j.visres.2017.03.002] [Citation(s) in RCA: 148] [Impact Index Per Article: 21.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Revised: 03/31/2017] [Accepted: 03/31/2017] [Indexed: 12/15/2022]
Abstract
Diabetic corneal alterations, such as delayed epithelial wound healing, edema, recurrent erosions, neuropathy/loss of sensitivity, and tear film changes are frequent but underdiagnosed complications of both type 1 (insulin-dependent) and type 2 (non-insulin-dependent) diabetes mellitus. The disease affects corneal epithelium, corneal nerves, tear film, and to a lesser extent, endothelium, and also conjunctiva. These abnormalities may appear or become exacerbated following trauma, as well as various surgeries including retinal, cataract or refractive. The focus of the review is on mechanisms of diabetic corneal abnormalities, available animal, tissue and organ culture models, and emerging treatments. Changes of basement membrane structure and wound healing rates, the role of various proteinases, advanced glycation end products (AGEs), abnormal growth and motility factors (including opioid, epidermal, and hepatocyte growth factors) are analyzed. Experimental therapeutics under development, including topical naltrexone, insulin, inhibitors of aldose reductase, and AGEs, as well as emerging gene and cell therapies are discussed in detail.
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26
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Zhang SD, He JN, Niu TT, Chan CY, Ren CY, Liu SS, Qu Y, Chong KL, Wang HL, Tao J, Pang CP. Bacteriological profile of ocular surface flora in meibomian gland dysfunction. Ocul Surf 2017; 15:242-247. [DOI: 10.1016/j.jtos.2016.12.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Revised: 12/30/2016] [Accepted: 12/31/2016] [Indexed: 12/17/2022]
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Conjunctival Microbial Flora in Ocular Stevens-Johnson Syndrome Sequelae Patients at a Tertiary Eye Care Center. Cornea 2017; 35:1117-21. [PMID: 27124779 DOI: 10.1097/ico.0000000000000857] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To evaluate the conjunctival microbial flora in cases of ocular Stevens-Johnson Syndrome (SJS) in a tertiary eye care center. METHODS This prospective study comprised 176 eyes of 88 patients with ocular SJS compared with 124 eyes of normal subjects. The conjunctival swabs were collected and sent for microbiological analysis for bacterial isolation and antibiotic sensitivity examination. The type of bacteria isolated and its antibiotic sensitivity pattern were studied. RESULTS Of 176 eyes, 104 (59%) had positive cultures for bacteria in cases of SJS and 16 (12.9%) had positive culture in the control group, the difference being statistically significant (P = 0.001). In the SJS group, 14 different types of bacterial isolates were identified. The most common isolate was coagulase-negative staphylococci (CNS) (30/104, 28.8%) followed by Corynebacteria species (35/104, 33.6%) and Staphylococcus aureus (19/104, 18.2%). More than 1 bacteria were isolated in 7 eyes (6.7%). Most of the isolates showed resistance to ciprofloxacin with no resistance to gatifloxacin and moxifloxacin. In the control group, only 2 bacteria were isolated, which included CNS (14/16, 87.5%) and Streptococcus pneumoniae (2/16, 12.5%). CNS showed resistance to ciprofloxacin, and S. pneumoniae was resistant to tobramycin and gentamycin. CONCLUSIONS Ocular SJS is associated with alteration of the normal microbial flora residing in the conjunctival sac. The study of which is vital in cases of infection in these eyes with compromised ocular surface. Mixed flora are seen more often in cases of ocular SJS as compared with controls.
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Kawata T, Matsuo T. Positive bacterial culture in conjunctival sac before cataract surgery with night stay is related to diabetes mellitus. BMC Ophthalmol 2017; 17:14. [PMID: 28219351 PMCID: PMC5319027 DOI: 10.1186/s12886-017-0413-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Accepted: 02/14/2017] [Indexed: 11/25/2022] Open
Abstract
Background The aim of this study is to elucidate background clinical factors in patients with positive bacterial culture for the conjunctival sac before cataract surgery in Japan. Methods Retrospective review was made on medical records of 576 consecutive patients who underwent conjunctival sac culture before cataract surgery with night stay at a hospital in 2 years from January 2013 to December 2014. In the patients with sequential bilateral surgeries, the data were chosen for bacterial culture in the eye which had earlier surgery. The age at surgery ranged from 33 to 100 years (mean, 76.7 years). Clinical factors, analyzed in relation with positive or negative bacterial culture, included the sex, the age, the presence of hypertension or diabetes mellitus, history of cancer, and history of hospital-based surgery at other specialties. Results Bacterial culture of the conjunctival sac was positive in 168 patients while negative in 408 patients. In multiple regression analysis, the positive bacterial culture was related with the older age (P = 0.01), the presence of diabetes mellitus (P = 0.004), and the history of hospital-based surgery at other specialties (P = 0.001). Conclusions Elderly patients with diabetes mellitus or previous hospital-based surgeries at other specialties have a higher rate of positive bacterial culture in the conjunctival sac before cataract surgery. This study would provide a hint for identifying patients at risk for carrying bacterial flora in the conjunctival sac.
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Affiliation(s)
- Tetsuhiro Kawata
- Department Ophthalmology, Okayama University Medical School and Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Okayama City, 700-8558, Japan.,Department of Ophthalmology, Fukuyama City Hospital, Fukuyama City, Japan
| | - Toshihiko Matsuo
- Department of Ophthalmology, Fukuyama City Hospital, Fukuyama City, Japan.
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Plotas P, Makri OE, Georgalas I, Pharmakakis N, Vantarakis A, Georgakopoulos CD. Efficacy of Topical Ofloxacin 0.3 % Administration on Conjunctival Bacterial Flora in Diabetic Patients Undergoing Intravitreal Injections. Semin Ophthalmol 2016; 32:738-742. [PMID: 27487463 DOI: 10.3109/08820538.2016.1170165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE This prospective, randomized case series study aims to evaluate the efficacy of ofloxacin 0.3% eye drops in eradication of conjunctival bacterial flora in diabetic patients undergoing intravitreal injections (IVI). METHODS Ninety-two diabetic patients (92 eyes) scheduled to undergo intravitreal injection of ranibizumab due to diabetic macular edema were enrolled in the study. Patients were randomly assigned to three different groups. Group 1 (n=32) received ofloxacin eye drops the day before before IVI (four times); patients in Group 2 (n=29) were administered ofloxacin one hour before IVI (every 15 minutes), while Group 3 (n=31) comprised patients that received combined administration of ofloxacin both one day and one hour before IVI (eight doses). Samples were collected from the injection site before and after antibiotic administration. Culture results from BACTEC broth and positive cultures in blood agar and Sabouraud's dextrose agar plates were measured. RESULTS In Group 1, BACTEC broth positive cultures decreased from 84.4% at baseline to 50% after ofloxacin administration (p=0.007), and blood agar positive cultures reduced from 65.63% to 34.38% (p=0.02). In Group 2, positive cultures significantly decreased in BACTEC broth (from 79.3% at baseline to 48.28%; p=0.027) and in blood agar (from 68.97% to 37.13%; p=0.034). In Group 3, positive cultures decreased from 77.42% at baseline to 32.26% (p=0.0008) and from 58.06% at baseline to 22.58% (p=0.009) in BACTEC broth and blood agar, respectively. No microorganisms were isolated from Sabouraud's dextrose agar plates. CONCLUSIONS The combined one day/one hour (eight doses) ofloxacin administration in diabetic patients is extremely effective in reducing conjunctival bacterial flora. The application of topical ofloxacin for one day or one hour before IVI is also significantly effective.
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Affiliation(s)
- Panagiotis Plotas
- a Department of Ophthalmology, Medical School , University of Patras , Patras , Greece.,b Laboratory of Public Health, School of Medicine , University of Patras , Patras , Greece
| | - Olga E Makri
- a Department of Ophthalmology, Medical School , University of Patras , Patras , Greece
| | - Ilias Georgalas
- c Department of Ophthalmology , University of Athens , Athens , Greece
| | - Nikolaos Pharmakakis
- a Department of Ophthalmology, Medical School , University of Patras , Patras , Greece
| | - Apostolos Vantarakis
- b Laboratory of Public Health, School of Medicine , University of Patras , Patras , Greece
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Hoshi S, Hashida M, Urabe K. Risk factors for aerobic bacterial conjunctival flora in preoperative cataract patients. Eye (Lond) 2016; 30:1439-1446. [PMID: 27419840 DOI: 10.1038/eye.2016.143] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 05/19/2016] [Indexed: 11/09/2022] Open
Abstract
PurposeTo investigate the relationship between the background of preoperative cataract patients and bacterial conjunctival flora.MethodsA total of 990 cataract patients who had completed preoperative examinations in 2007 and 2008 were included. Patients using topical antibiotics at the preoperative examination or having a history of intraocular surgery were excluded. Conjunctival cultures had been preoperatively obtained. Patient characteristics were investigated via medical records. Risk factors for conjunctival flora of seven typical bacteria were analyzed by univariate and multivariate analyses.ResultsThe detection rate of alpha-hemolytic streptococci and Enterococcus faecalis increased with age (P=0.044 and P=0.002, respectively). The detection rate of Gram-negative bacilli was higher among patients with oral steroid use or lacrimal duct obstruction (P=0.038 and P=0.002, respectively). The detection rate of Corynebacterium species was higher among older patients and men, and lower among patients with glaucoma eye drop use (P<0.001, P=0.012 and P=0.001, respectively). The detection rate of methicillin-susceptible coagulase-negative Staphylococci was higher among men and lower among patients with a surgical history in other departments (P=0.003 and P=0.046, respectively). The detection rate of methicillin-resistant coagulase-negative Staphylococci (MR-CNS) was higher among patients with oral steroid use, a visit history to ophthalmic facilities, or a surgical history in other departments (P=0.002, P=0.037 and P<0.001, respectively).ConclusionsElderly patients, men, patients with lacrimal duct obstruction or immunosuppressed patients are more likely to be colonized by pathogens that cause postoperative endophthalmitis. Moreover, MR-CNS colonization was associated with healthcare-associated infection.
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Affiliation(s)
- S Hoshi
- Department of Ophthalmology, National Center for Geriatrics and Gerontology, Obu, Japan
| | | | - K Urabe
- Machida Eye Hospital, Kochi, Japan
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Endophthalmitis caused by Staphylococcus hominis and two different colonies of Staphylococcus haemolyticus after cataract surgery. Retin Cases Brief Rep 2015; 9:181-4. [PMID: 25764314 DOI: 10.1097/icb.0000000000000133] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To describe a case of endophthalmitis after cataract surgery caused by Staphylococcus hominis and two separate colony types of Staphylococcus haemolyticus. METHODS Retrospective chart review including ophthalmic examination, intraocular biopsy and cultures, and anterior segment photography. RESULTS A patient presented with endophthalmitis 1 month after cataract surgery. The patient underwent pars plana vitrectomy with vitreous fluid, aqueous fluid, and lens capsule biopsy with injection of intravitreal antimicrobials with full resolution of the infection. Cultures isolated grew S. hominis and two different colonies of S. haemolyticus, all sensitive to vancomycin. CONCLUSION To the best of the authors' knowledge, this is the first case of endophthalmitis due to lens capsule seeding from three different types of bacteria, S. hominis and two different colony types of S. haemolyticus. Prompt diagnosis and treatment can be associated with good visual outcomes.
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Rayess N, Rahimy E, Shah CP, Wolfe JD, Chen E, DeCroos FC, Storey P, Garg SJ, Hsu J. Incidence and clinical features of post-injection endophthalmitis according to diagnosis. Br J Ophthalmol 2015; 100:1058-61. [PMID: 26584579 DOI: 10.1136/bjophthalmol-2015-307707] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Accepted: 10/24/2015] [Indexed: 11/03/2022]
Abstract
PURPOSE To compare the incidence and clinical features of endophthalmitis after intravitreal antivascular endothelial growth factor (VEGF) therapy for diabetic eye disease, neovascular age-related macular degeneration (AMD) and retinal vein occlusion (RVO). METHODS Multicentre, retrospective, consecutive case-control study. All patients treated with intravitreal bevacizumab, ranibizumab or aflibercept for diabetic eye disease, neovascular AMD or RVO between 1 January 2009 and 30 September 2013 at three retina practices were included in this study. The total number of anti-VEGF injections administered for the three indications was calculated using billing records. Endophthalmitis cases were identified using both endophthalmitis log sheets and billing records. Patient charts were reviewed to confirm that endophthalmitis was directly related to anti-VEGF injection and to record clinical features and culture results. RESULTS During the study period, a total of 353 978 intravitreal anti-VEGF injections were performed. Presumed infectious endophthalmitis occurred in 119 of 296 017 injections performed for neovascular AMD (1/2487, 0.040%), 12 of 24 541 for diabetic eye disease (1/2045, 0.049%) and 4 of 32 418 for RVO (1/8104, 0.012%). χ(2) analysis found endophthalmitis rates to be higher in diabetic eye disease compared with RVO (p=0.010) and higher in neovascular AMD compared with RVO (p=0.014), while diabetic eye disease and neovascular AMD (p=0.517) had similar rates. The average age of the overall neovascular AMD patient population (81.9 years) was significantly older than the diabetic eye disease (64.7 years, p<0.001) and RVO (73.4 years, p<0.001) populations. CONCLUSIONS Endophthalmitis rates appear to be lower in eyes with RVO compared with diabetic eye disease and neovascular AMD, possibly due to impaired immunity in diabetics and waning immunity in the generally older AMD population.
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Affiliation(s)
- Nadim Rayess
- The Retina Service of Wills Eye Hospital, Philadelphia, Pennsylvania, USA
| | - Ehsan Rahimy
- The Retina Service of Wills Eye Hospital, Philadelphia, Pennsylvania, USA
| | - Chirag P Shah
- Ophthalmic Consultants of Boston, Boston, Massachusetts, USA
| | | | - Eric Chen
- Retina Consultants of Houston, Houston, Texas, USA
| | | | - Philip Storey
- The Retina Service of Wills Eye Hospital, Philadelphia, Pennsylvania, USA
| | - Sunir J Garg
- The Retina Service of Wills Eye Hospital, Philadelphia, Pennsylvania, USA
| | - Jason Hsu
- The Retina Service of Wills Eye Hospital, Philadelphia, Pennsylvania, USA
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Adam M, Balcı M, Bayhan HA, İnkaya AÇ, Uyar M, Gürdal C. Conjunctival Flora in Diabetic and Nondiabetic Individuals. Turk J Ophthalmol 2015; 45:193-196. [PMID: 27800231 PMCID: PMC5082240 DOI: 10.4274/tjo.33230] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2014] [Accepted: 12/29/2014] [Indexed: 02/06/2023] Open
Abstract
Objectives: To evaluate the conjunctival bacterial flora in diabetic patients and nondiabetic subjects. Materials and Methods: Fifty-three diabetic patients and 43 nondiabetic healthy individuals were included in the study. A specimen was taken from each participant for the study by rubbing a sterile cotton-tipped swab on the inferior palpebral conjunctiva of the right eye. Samples were incubated in blood agar, chocolate agar, eosin methylene-blue lactose sucrose agar and sabouraud 4% dextrose agar. Isolated microorganisms were identified using routine microbiological methods. Results: Rates for bacterial isolations were determined as 38.5% in diabetic patients and 34.9% in nondiabetic controls. Staphylococcus aureus was isolated in 30% of cases in the diabetic patient group, while 20% tested positive for Escherichia coli, 10% for coagulase-negative Staphylococcus, 10% for Klebsiella pneumoniae and 30% for multiple bacteria. In the non-diabetic group, 53.3% of patients were positive for Staphylococcus aureus while coagulase-negative Staphylococcus was isolated in 26.7%, Klebsiella pneumoniae in 6.7% and multiple bacteria in 13.3% of patients. Although there was no statistically significant difference in the number of isolated bacteria between the diabetic and nondiabetic groups, gram-negative bacterial colonization was significantly higher in diabetic patients (χ2=0.129, p=0.719 and χ2=5.60, p=0.018, respectively). Conclusion: Gram-negative bacteria are more common in the conjunctival flora of diabetic patients. This should be considered by clinicians when treating ocular infections in diabetic patients.
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Affiliation(s)
- Mehmet Adam
- Bozok University Faculty of Medicine, Department of Ophthalmology, Yozgat, Turkey
| | - Mehmet Balcı
- İzzet Baysal State Hospital, Clinic of Infectious Disease and Microbiology, Bolu, Turkey
| | - Hasan Ali Bayhan
- Bozok University Faculty of Medicine, Department of Ophthalmology, Yozgat, Turkey
| | - Ahmet Çağkan İnkaya
- Hacettepe University Faculty of Medicine, Department of Infectious Disease and Clinical Microbiology, Ankara, Turkey
| | - Mehmet Uyar
- Necmettin Erbakan University Faculty of Medicine, Department of Public Health, Konya, Turkey
| | - Canan Gürdal
- Bozok University Faculty of Medicine, Department of Ophthalmology, Yozgat, Turkey
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Zhang Y, Zhang H. Microbiota associated with type 2 diabetes and its related complications. FOOD SCIENCE AND HUMAN WELLNESS 2013. [DOI: 10.1016/j.fshw.2013.09.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Pathogenic conjunctival bacteria associated with systemic co-morbidities of patients undergoing cataract surgery. Eye (Lond) 2013; 27:915-23. [PMID: 23703631 DOI: 10.1038/eye.2013.103] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2012] [Accepted: 04/28/2013] [Indexed: 11/09/2022] Open
Abstract
PURPOSE To identify the risk of patients undergoing cataract surgery of having pathogenic conjunctival bacteria associated with their systemic co-morbidities. METHODS Retrospective study of consecutive patients undergoing their first cataract operation from July 2005 to April 2010. Their preoperative conjunctival bacteria were cultured, identified, and classified in bacterial groups. Their co-morbidities were defined from their clinical data and the answers to systematic questions asked in the anaesthetic evaluation. The Microsoft Access databases of the two data sets were merged for carrying out the statistical analysis. Univariate association of each bacterial group with each co-morbidity was studied by using χ(2)-test for categorical data and Student's t-test for continuous variables. Also, logistic regression models were used adjusting for age and sex. SPSS statistic programme, version 18 was used for all these analyses. Endophthalmitis cases in this surgical series were searched. RESULTS In the 8333 selected patients, age was associated with increased conjunctival bacteria in all groups except for Streptococcus pneumoniae and Propionibacteriae. However, male sex was associated with these two groups and also with coagulase-negative Staphylococci, Corynebacterium xerosis, Staphylococcus aureus, and Gram-negative rods. After adjusting for age and sex, S. aureus was associated with diabetes, lung diseases, and renal and heart insufficiency; Gram-negative rods with smoking habit; Enterococci with diabetes; Streptococcus pneumoniae with kyphoscoliosis; and other Streptococci with diabetes and handicapped patients. CONCLUSION The more pathogenic conjunctival bacteria were more likely associated with patients' co-morbidities, such as diabetes, lung diseases, renal and heart insufficiency, kyphoscoliosis, and smoking habit, than the less pathogenic ones.
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Balikoglu-Yilmaz M, Sen E, Sevket O, Polat Y, Karabulut A, Uysal O. Comparison of aerobic conjunctival bacterial flora in pregnant, reproductive-aged and postmenopausal women. Int J Ophthalmol 2012; 5:731-6. [PMID: 23275909 DOI: 10.3980/j.issn.2222-3959.2012.06.15] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2012] [Accepted: 11/20/2012] [Indexed: 01/06/2023] Open
Abstract
AIM To evaluate the effect of hormonal status on aerobic conjunctival flora in women. METHODS One hundred fifty-eight women [reproductive-aged (n=55), pregnant (n=51), and postmenopausal (n=52)] who admitted to outpatient clinic of Obstetrics and Gynecology Department of Denizli State Hospital were enrolled. Age, body-mass index (BMI), obstetric history, cigarette smoking, drug usage, presence of systemic disease, and intraocular pressure (IOP) were recorded for each patient. The samples were taken from the lower fornix with two culture swabs and directly incubated in culture containing 5% sheep blood, eosin-methylene blue and chocolate agar. The other swab specimen was Gram stained. All growths and microscopic results were analyzed. RESULTS The coagulase-negative Staphylococcus was the predominant organism isolated in the conjunctival samples in both three groups. The aerobic microorganism growth rate for all isolated aerobic organisms revealed no significant change in the three groups (P >0.05). The conjunctival culture positivity rates were similar in the three groups (49% in reproductive-aged, 57% in pregnant and 58% in postmenopausal women) (P >0.05). Age, IOP, BMI, gravidity, parity, cigarette smoking, drug usage, and presence of systemic diseases did not have an effect on culture positivity in three groups. CONCLUSION Results of this study showed that conjunctival aerobic flora and bacterial colonization did not differ between reproductive-aged, pregnant and postmenopausal women.
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Honda R, Toshida H, Suto C, Fujimaki T, Kimura T, Ohta T, Murakami A. Effect of long-term treatment with eyedrops for glaucoma on conjunctival bacterial flora. Infect Drug Resist 2011; 4:191-6. [PMID: 22114511 PMCID: PMC3215341 DOI: 10.2147/idr.s24250] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2011] [Indexed: 11/23/2022] Open
Abstract
Objective: The effect of eyedrops for glaucoma on conjunctival bacterial flora was investigated by comparing a group of patients treated with such eyedrops for at least 1 year to a control group that did not use eyedrops. Methods: In both groups, bacterial culture came from scrapings of the conjunctival sac, and the bacterial infection rate and pattern of drug resistance were determined. Findings were analyzed in various subgroups stratified by age, frequency of instillation, and concentration of antiseptic benzalkonium chloride in the eyedrops. Results: The culture-positive rate was significantly lower in the glaucoma eyedrop group (43/119 eyes, 40.3%) than in the control group (19/28 eyes, 67.8%) (P < 0.05). No differences in infection rate were found among the different age groups. The most frequent bacteria in both groups was coagulase-negative staphylococci. Gram-negative bacteria were only detected in the glaucoma eyedrop group. Retrospective evaluation was possible for 86 eyes of patients from the glaucoma eyedrop group, among which 45 eyes (52.3%) showed some corneal epithelium damage. There was no difference in the culture-positive rate of bacteria between patients who used eyedrops containing 0.01% or higher dose of benzalkonium chloride and those containing less than 0.01%. Strains that showed resistance to levofloxacin were significantly less frequent in the glaucoma eyedrop group (six strains, 15.0%) than in the control group (11 strains, 39.3%) (P < 0.05). Conclusion: Patients using eyedrops for glaucoma had a lower culture-positive rate of bacteria in the conjunctival sac, probably due to being washed out by the eyedrops. However, Gram-negative bacteria were detected in the eyedrop group. Bacteria isolated from the eyedrop group had lower resistance to levofloxacin, a finding that may have clinical relevance.
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Affiliation(s)
- Rio Honda
- Department of Ophthalmology, Juntendo University Shizuoka Hospital, Izunokuni, Shizuoka
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Hu VH, Massae P, Weiss HA, Chevallier C, Onyango JJ, Afwamba IA, Mabey DCW, Bailey RL, Burton MJ. Bacterial infection in scarring trachoma. Invest Ophthalmol Vis Sci 2011; 52:2181-6. [PMID: 21178143 DOI: 10.1167/iovs.10-5829] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
PURPOSE To assess whether non-chlamydial bacterial infection is associated with trachomatous scarring in adults. METHODS This was a case-control study of 360 cases with trachomatous scarring but without trichiasis, and 360 controls without scarring. All participants underwent clinical examination, and a swab was taken from the inferior conjunctival fornix. Samples were inoculated onto blood and chocolate agar later that day. RESULTS Bacterial isolates were identified in 54.0% of cases compared with 34.6% of controls (P < 0.001). A multivariate logistic regression model adjusted for age and lack of education showed that scarring was associated with the presence of commensal organisms (odds ratio [OR], 1.46; 95% confidence interval [CI], 1.01-2.09) and was strongly associated with the presence of pathogenic organisms (OR, 4.08; 95% CI, 1.59-10.45). There was an increasing prevalence of all bacterial isolates with increasing severity of scarring (P(trend) < 0.001). CONCLUSIONS Trachomatous scarring is strongly associated with non-chlamydial bacterial infection compared with controls. The role of such infection with regard to scarring progression should be investigated and may have important implications for trachoma control strategies and prevention of blindness.
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Affiliation(s)
- Victor H Hu
- International Centre for Eye Health, Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, London, UK.
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Capriotti JA, Pelletier JS, Shah M, Caivano DM, Turay P, Ritterband DC. The etiology of infectious corneal ulceration in Sierra Leone. Int Ophthalmol 2010; 30:637-40. [PMID: 20111889 DOI: 10.1007/s10792-010-9348-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2008] [Accepted: 12/22/2009] [Indexed: 11/27/2022]
Abstract
The microbial etiology of infectious corneal ulceration in Sierra Leone has been investigated. Patients either presenting to district health centers or encountered on rural surveillance expeditions with suspected infectious ulcerative keratitis were recruited into the study. Infectious corneal ulceration was defined as clinical evidence of corneal infection with epithelial defect with or without hypopyon. Cultures were obtained in a standard fashion and subsequent microbial analysis performed on all specimens. Seventy-three (73) cases of suspected infectious ulcerative keratitis were obtained between January 2005 and January 2006. The most commonly isolated organisms from microbial cultures of infected eyes were Gram-negative bacteria (45.2%), Gram-positive bacteria (37.0%), and fungal species (35.6%). Mixed bacterial and fungal organisms were isolated from ten eyes (13.7%) and no organisms were isolated from four eyes (5.5%). There is a high incidence of Gram-negative and fungal ulcerative keratitis in the population studied in Sierra Leone. Empirical therapy for corneal ulceration in this region should be aimed towards treatment of bacterial, fungal, and mixed infections.
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Affiliation(s)
- J A Capriotti
- The New York Eye and Ear Infirmary, New York, NY, USA
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Fernández-Rubio ME, Rebolledo-Lara L, Martinez-García M, Alarcón-Tomás M, Cortés-Valdés C. The conjunctival bacterial pattern of diabetics undergoing cataract surgery. Eye (Lond) 2009; 24:825-34. [PMID: 19713978 DOI: 10.1038/eye.2009.218] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE To ascertain the conjunctival bacterial pattern of diabetics undergoing cataract operation to reduce the risk of postoperative endophthalmitis (PE). METHODS An observational retrospective study of the conjunctival bacteria of consecutive patients undergoing cataract surgery from July 2005 to November 2008. Records of patients having eye surgical prophylaxis in the 6 months before the culture and those patients having cataract operation combined with other surgical procedures were excluded. Aerobic and microaerobic cultures were carried out. Dade-Behring panels were used for bacterial identification. The database containing the isolated bacteria was linked to another Access database containing demographic and clinical data such as diabetes presence and baseline blood glucose and creatinine levels. The conjunctival bacteria of diabetics were compared with those of the non-diabetics. Epidat 3.1 program was used for statistical calculations. RESULTS From 5922 selected patients, 1325 (22.37%) knew they were diabetics (higher prevalence than expected). Among self-reported non-diabetics, 900 (15.2%) could be 'unknown' diabetics; another 274 had an impaired renal function; and 3423 non-diabetics joined the control group. Diabetics have a significantly higher prevalence of Staphylococcus aureus, Enterococci, certain Streptococci, and Klebsiella sp. than non-diabetics. Diabetics and non-diabetics having a blood creatinine level above 105.2 mumol/l had an increased conjunctival bacterial prevalence; these groups had a higher mean age and men predominated. CONCLUSIONS Diabetics have a conjunctival flora pattern whose increased bacteria are a predominant cause of many diabetic infections. An abnormally high blood creatinine level is an indicator of increased conjunctival colonisation in diabetics and non-diabetics.
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Affiliation(s)
- M E Fernández-Rubio
- Ophthalmic Institute Laboratory, Department of Ophthalmology, 'Gregorio Marañón' University General Hospital, Madrid, Spain.
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Kusbeci T, Kusbeci ÖY, Aktepe OC, Yavas G, Ermis SS. Conjunctival Flora in Patients with Parkinson's Disease. Curr Eye Res 2009; 34:251-6. [DOI: 10.1080/02713680902725970] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Effect of chronic topical glaucoma medications on aerobic conjunctival bacterial flora. Cornea 2009; 28:266-70. [PMID: 19387226 DOI: 10.1097/ico.0b013e3181861c11] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To investigate whether the chronic topical medications affect aerobic conjunctival bacterial flora of patients with glaucoma and to compare their findings with the findings of the controls. METHODS Eighty-one patients and 67 healthy control subjects participated in this case-control study. Duplicate conjunctival swab specimens were collected from each patient at the microbiology laboratory and were investigated for the presence of aerobic bacteria. All bacterial species from isolated colonies were identified. RESULTS Thirty seven (45.7%) of the 81 patients and 25 (37.3%) of 67 controls had positive conjunctival cultures. Coagulase-negative Staphylococcus was the most commonly isolated bacterial species in both groups. There were no statistically significant differences between the prevalence of other conjunctival cultures testing positive for any of the isolated organisms. The patients were also evaluated with respect to the presence of a systemic illness. Age, sex, presence of diabetes and asthma, duration of antiglaucomatous medication, and number of medications used did not have an effect on culture positivity in both groups when evaluated by logistic regression model. CONCLUSIONS The conjunctival culture positivity was higher in patients with glaucoma than in the healthy controls and in patients with diabetes than in patients without diabetes, although both were statistically insignificant. Aerobic conjunctival flora of the patients using topical glaucoma medications and the controls did not differ. Further studies are needed to comment on the clinical importance of these findings.
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Normal ocular flora in healthy eyes from a rural population in Sierra Leone. Int Ophthalmol 2008; 29:81-4. [DOI: 10.1007/s10792-008-9196-4] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2007] [Accepted: 01/14/2008] [Indexed: 11/28/2022]
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Abstract
Acute bacterial conjunctivitis is the eye disease most commonly seen by general practitioners, and is estimated to represent approximately 1% of all consultations in primary care. This article gives a review of the epidemiology, aetiology, clinical picture, complications, differential diagnoses, in vitro examinations and therapy of acute bacterial conjunctivitis. Until now, topical antibacterial therapy has generally been preferred by both physicians and patients because this will usually shorten the course of the disease slightly and allow the early readmittance of children to their kindergarten or school. Recently, several reports from primary care have confirmed the well-known clinical experience that the disorder has an excellent prognosis with a high frequency of spontaneous remission. In accordance, an expectant attitude or delayed prescription policy are now frequently strongly recommended. However, these reports also emphasize the difficulty in making a correct clinical distinction between bacterial and viral conjunctivitis. The effect of a general non-prescription attitude on transmission rates of pathogens also remains to be clarified. This must be born in mind when deciding how these patients should be handled. The socioeconomic and medical pros and cons of different treatment policies are discussed, and a highly personal view on the optimal handling strategy for these patients is also presented.
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Affiliation(s)
- Gunnar Høvding
- Department of Clinical Medicine, Section of Ophthalmology, University of Bergen, and Haukeland University Hospital, Bergen, Norway.
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