Abstract

P 231

Antibiotic resistance patterns of ocular bacterial flora of patients with and without chronic blepharoconjunctivitis

Yazmin Yactayo, Martin M. Nentwich, Markus Schaumberger, Anselm Kampik, Herminia Mino De Kaspar
Augenklinik der Ludwig-Maximilians-Universität München, München

Objective
To compare the antibiotic susceptibility patterns of conjunctival bacterial flora isolated from patients with and without chronic blepharoconjunctivitis (CBC).
Methods
Patients with CBC (n = 60) and without CBC (n = 40) were enrolled after approval by the Ethics Commitee of Ludwig-Maximilian University and by the Institutional Review Board.. Conjunctival cultures were obtained from both eyes and inoculated into thioglycolate broth for bacterial growth. Collection of specimens from the conjunctival sac was performed by rotation of a swab moistened in thioglycolate through the inferior fornix from the nasal to the temporal side, covering all sides of the swab. Identification of organisms and antibiotic susceptibility testing were performed with the Vitek 2 Compact system (bioMérieux®)
Results
Fifty-two patients with completed the study. These patients with CBC had a significantly higher rate of positive thioglycolate broth cultures (94%) compared to a 58% positive culture rate in patients without CBC (P < 0.0001). Among the 142 bacteria isolated the most common were coagulase-negative Staphylococcus (CNS), 81,8% in patients without CBC and 69,4 % in patients with CBC. The rates of antibiotic resistance for CNS in the group with CBC were high to the penicillins (82,4%), mezlocillin (60,3%), ciprofloxacin (22,1%), norfloxacin and ofloxacin (20,6%) and levofloxacin (17,7%). In the group without CBC resistance rates were as follows: the penicillins (69,4%), mezlocilin (27,8 %), ciprofloxacin (11,1 %), norfloxacin, ofloxacin and levofloxacin with (13,9%). In both groups CNS were relatively more sensitive to the cephalosporins, imipenem, meropenem, aminoglycoside, gatifloxacin, moxifloxacin and vancomycin.
Conclusions
CBC eyes have a significantly higher number of positive cultures compared to eyes without CBC. Coagulase negative Staphylococcus in patients with CBC showed a higher rate of resistance against certain antibiotics in comparison to patients without CBC. One reason might be the selection of resistant bacteria by previous antibiotic treatment in the CBC group. On the other hand, we recommend that patients with blepharoconjunctivitis who are scheduled for intraocular surgery may benefit from a course of topical antibiotic prior to surgery to reduce the bacterial count.

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