Journal List > J Korean Ophthalmol Soc > v.54(4) > 1009638

Saem and Min: Comparison of Bacterial Culture Rate and Bacterial Floral Distribution in Anophthalmic Patients with Prosthetic Eye, Between Patients with Symptom and Without Symptom

Abstract

Purpose

To evaluate the distribution of conjunctival bacterial flora in anophthalmic socket patients with a prosthetic eye, and compare the bacterial positive culture rates between patients with subjective symptoms such as eye wax or irritation and patients without symptoms.

Methods

Twenty-six anophthalmic socket patients with a prosthetic eye who visited our clinic between December 2009 and May 2011 were retrospectively analyzed. The patients were asked about their symptoms, followed by a conjunctiva examination. Specimens were obtained from the inferior conjunctival cul- de- sac with a sterile cotton-tipped applicator. The collected specimens were cultured.

Results

The results indicated that the overall positive culture rate in the anophthalmic conjunctival socket was 69.2%, and the predominant organism was S. epidermidis (38.5%). Potential pathogenic bacteria were found in 4 eyes with a 15% positive culture rate. The incidence of bacteria was significantly higher (85.4%) in patient samples with subjective symptoms compared to patients without symptoms (50%). The bacterial positive culture rate of the potential pathogen bacteria in the group with symptoms was higher at 21%, but was not statistically significant.

Conclusions

Performing a pathogen culture test is necessary for prosthetic eye patients who complain of their symptoms. Additionally, the proper antibacterial treatment should be performed according to the antibiotics sensitivity of cultured bacteria.

References

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Figure 1.
Correlation between bacterial positive culture rate and causes of enucleation.
jkos-54-552f1.tif
Figure 2.
Correlation between bacterial species and causes of enucleation.
jkos-54-552f2.tif
Table 1.
Incidence of the various microorganisms found in the conjunctival sac
Microorganisms No. of cases (%)
Cogulase negative staphylococcus (CNS)* 1 (3.8)
 S. aureus 1 (3.8)
 S. epidermidis 10 (38.7)
 Streptococcus spp. 1 (3.8)
 Enterococcus faecalis 1 (3.8)
 Gram-positive bacilli 2 (7.6)
 Gram-negative bacilli 2 (7.6)
 Potential pathogenic bacteria 4 (22.8)
No growth 8 (30.8)
Total 26

* This group excludes S. epidermidis

This group includes: S. aureus, streptococcus spp. and gram-negative bacilli.

Table 2.
Correlation between bacterial positive culture rate and symptoms
Microorganisms Symptoms (%) No symptoms (%) Total Paired t-test
Growth 12 (85.7%) 6 (50%) 18
p < 0.05
p = 0.049
Cogulase negative staphylococcus* 1 (7.1%) 0 1
S. aureus 1 (7.1%) 0 1
S. epidermidis 5 (35.7%) 5 (41.7%) 10
Streptococcus spp. 0 1 (8.3%) 1
Enterococcus faecalis 1 (7.1%) 0 1
Gram-positive bacilli 2 (14.2%) 0 2
Gram-negative bacilli 2 (14.2%) 0 2
Potential pathogenic bacteria* 3 (21.4%) 1 (8.3%) 4 n.s.* p = 0.356
No growth 2 (14.2%) 6 (50%) 8
Total 14 12 26 (100%)

* Not significant on 5% level.

Table 3.
Antimicrobial sensitivity patterns of microorganisms isolated from anophthalmic conjunctival sac
Antimicrobial agent CNS % (S) S. aureus % (S) S. epidermidis % (S) Streptococcus % (S) Gram-negative bacilli % (S) Gram-positive bacilli % (S) Total % (S)
Ciprofloxacin 100 100 50 100 NT NT 87.5
Clindamycin 100 100 75 100 NT NT 93.7
Erythromycin 100 100 66.7 100 NT NT 91.7
Gentamicin 100 0 50 100 NT NT 62.5
Oxacillin 100 100 33.3 0 NT NT 58.3
Penicillin G 0 0 0 0 NT NT 0
Teicoplanin 100 100 100 100 NT NT 100
Vancomycin 100 100 100 100 NT NT 100
Trimethoprim / Sulfamethoxazole 100 100 72.7 100 NT NT 93.1
Tetracyclin 100 100 41.7 100 NT NT 85.4
Table 4.
Causes of enucleation of 26 eyes
Causes No. of cases (%)
Perforating injury 9 (34.6)
Phthisis bulbi 7 (26.9)
Corneal ulcer perforation 5 (19.3)
Endophthalmitis 2 (7.7)
Implant exposure 2 (7.7)
Retinoblastoma 1 (3.8)
Total 26
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