Top

International Ophthalmology

Published in:

03-07-2023 | Conjunctivitis | Original Paper

Microbiological spectrum and antibiotic susceptibility patterns of non-viral conjunctivitis over 16 years at a tertiary eye care center in Southern India

Authors: Sreyasi Maiti, Jaishree Gandhi, Joveeta Joseph

Published in: International Ophthalmology | Issue 10/2023

Abstract

Purpose

To determine the trends in the microbial spectrum and antibacterial susceptibility patterns of non-viral conjunctivitis over 16 years.

Methods

Microbiology data were reviewed from 2006–2021 for all the patients with clinically and culture-proven infectious conjunctivitis. Conjunctival swabs and/or conjunctival scrapings were collected for microbiological workup, and the demographic and antibiotic susceptibility data were extracted from the EMR (Electronic Medical Record). For statistical analysis, χ²-test was performed.

Results

Of the 1711 patients, 814 (47.57%) were culture positive and 897 (52.43%) were culture negative. Of the total culture-proven conjunctivitis cases, 775/814 (95.20%) were bacteria, and 39/814 (4.80%) were fungi. Among these bacterial isolates, 75.74% were gram-positive bacteria, while 24.26% were gram negative. The predominant gram-positive pathogens isolated were S. epidermidis (16.7%), S. aureus (17.9%) (p < 0.05), and S. pneumoniae (18.2%), while Haemophilus spp. (36.2%) (p < 0.05) was the most often isolated gram-negative bacteria (36.2%), and Aspergillus spp. was the most commonly isolated fungus (50%). The susceptibility of gram-positive bacteria to cefazoline increased from 90.46 to 98% (p = 0.01), whereas the susceptibility for gatifloxacin decreased in both gram-positive (81–41%; p < 0.0001) and gram-negative bacteria (73–58%; p = 0.02).

Conclusions

Increasing resistance of ocular isolates to mainstay antibiotics is a concern, and this data can assist healthcare practitioners in making informed choices regarding the treatment of ocular infections with ophthalmic antibiotics.

Hosny AES, El-Bazza ZE, Ramadan MA et al (2021) Expression levels of pro-inflammatory interleukin-8 and certain antimicrobial peptides in concurrent with bacterial conjunctivitis. Int J Ophthalmol 14:666–675. https://doi.org/10.18240/ijo.2021.05.05CrossRefPubMedPubMedCentral

Høvding G (2008) Acute bacterial conjunctivitis. Acta Ophthalmol 86:5–17. https://doi.org/10.1111/j.1600-0420.2007.01006.xCrossRefPubMed

Mohamed YH, Uematsu M, Morinaga Y et al (2021) Conjunctival sac microbiome in infectious conjunctivitis. Microorganisms 9:2095. https://doi.org/10.3390/microorganisms9102095CrossRefPubMedPubMedCentral

Adebayo A, Parikh JG, McCormick SA et al (2011) Shifting trends in in vitro antibiotic susceptibilities for common bacterial conjunctival isolates in the last decade at the New York Eye and Ear Infirmary. Graefes Arch Clin Exp Ophthalmol 249:111–119. https://doi.org/10.1007/s00417-010-1426-6CrossRefPubMed

Azari AA, Barney NP (2013) Conjunctivitis: a systematic review of diagnosis and treatment. JAMA 310:1721–1730. https://doi.org/10.1001/jama.2013.280318CrossRefPubMedPubMedCentral

Sthapit PR, Tuladhar NR, Marasini S et al (2011) Bacterial conjunctivitis and use of antibiotics in Dhulikhel Hospital-Kathmandu University Hospital. Kathmandu Univ Med J 9:69–72. https://doi.org/10.3126/kumj.v9i2.6292CrossRef

Shrestha SP, Khadka J, Pokhrel AK et al (2016) Acute bacterial conjunctivitis–antibiotic susceptibility and resistance to commercially available topical antibiotics in Nepal. Nepal J Ophthalmol 8:23–35. https://doi.org/10.3126/nepjoph.v8i1.16153CrossRefPubMed

Alfonso SA, Fawley JD, Lu XA (2015) Conjunctivitis. Prim Care: Clin Office Pract 42(3):325–345. https://doi.org/10.1016/j.pop.2015.05.001CrossRef

Haq A, Wardak H, Kraskian N (2013) Infective conjunctivitis–its pathogenesis, management and complications. Common Eye Infect. https://doi.org/10.5772/52462CrossRef

10.

Biswas P, Batra S, Gurha N et al (2022) Emerging antimicrobial resistance and need for antimicrobial stewardship for ocular infections in India: a narrative review. Indian J Ophthalmol 70(5):1513. https://doi.org/10.4103/ijo.IJO_2537_21CrossRefPubMedPubMedCentral

11.

Kunimoto DY, Das T, Sharma S et al (1999) Microbiologic spectrum and susceptibility of isolates. Part I postoperative endophthalmitis. Am J Ophthalmol 128:240–242. https://doi.org/10.1016/s0002-9394(99)00112-9CrossRefPubMed

12.

Kunimoto DY, Das T, Sharma S et al (1999) Microbiologic spectrum and susceptibility of isolates. Part II posttraumatic endophthalmitis. Am J Ophthalmol 128:242–244. https://doi.org/10.1016/s0002-9394(99)00113-0CrossRefPubMed

13.

Sharma S, Kunimoto DY, Garg P et al (1999) Trends in antibiotic resistance of corneal pathogens: Part I. An analysis of commonly used ocular antibiotics. Indian J Ophthalmol 47:95–100

14.

Sharma S, Jalali S, Adiraju MV et al (1996) Sensitivity and predictability of vitreous cytology, biopsy, and membrane filter culture in endophthalmitis. Retina (Philadelphia, Pa.) 16(6):525–529. https://doi.org/10.1097/00006982-199616060-00010CrossRefPubMed

15.

Kaliamurthy J, Kalavathy CM, Parmar P, Thomas PA et al (2013) Spectrum of bacterial keratitis at a tertiary eye care centre in India. BioMed Res Int. https://doi.org/10.1155/2013/181564CrossRefPubMedPubMedCentral

16.

Wolfensberger A, Sax H, Weber R, Zbinden R, Kuster SP, Hombach M. Change of antibiotic susceptibility testing guidelines from CLSI to EUCAST: influence on cumulative hospital antibiograms. PloS one. 2013 Nov 1;8(11):e79130.

17.

Tarabishy AB, Jeng BH (2008) Bacterial conjunctivitis—a review for internists. Clevel Clin J Med 75:507. https://doi.org/10.3949/ccjm.75.7.507CrossRef

18.

Gigliotti F, Williams WT, Hayden FG et al (1981) Etiology of acute conjunctivitis in children. J Pediatr 98:531–536. https://doi.org/10.1016/s0022-3476(81)80754-8CrossRefPubMed

19.

Schmitz H, Wigand R, Heinrich W (1983) Worldwide epidemiology of human adenovirus infections. Am J Epidemiol 117(4):455–466. https://doi.org/10.1093/oxfordjournals.aje.a113563CrossRefPubMed

20.

Fitch CP, Rapoza PA, Owens S et al (1989) Epidemiology and diagnosis of acute conjunctivitis at an inner-city hospital. Ophthalmology 96:1215–1220. https://doi.org/10.1016/s0161-6420(89)32749-7CrossRefPubMed

21.

Block SL, Hedrick J, Tyler R et al (2000) Increasing bacterial resistance in pediatric acute conjunctivitis (1997–1998). Antimicrob Agents Chemother 44:1650–1654. https://doi.org/10.1128/AAC.44.6.1650-1654.2000CrossRefPubMedPubMedCentral

22.

Aoki K, Tagawa Y (2002) A twenty–one year surveillance of adenoviral conjunctivitis in Sapporo, Japan. Int Ophthalmol Clin 42:49–54. https://doi.org/10.1097/00004397-200201000-00008CrossRefPubMed

23.

Valentino MD, McGuire AM, Rosch JW et al (2014) Unencapsulated Streptococcus pneumoniae from conjunctivitis encode variant traits and belong to a distinct phylogenetic cluster. Nat Commun 12(5):5411. https://doi.org/10.1038/ncomms6411CrossRef

24.

Mokbul MI, Islam AK, Tabassum MN et al (2022) Recent incidence of infectious conjunctivitis in Bangladesh: are we aware? Ann Med Surg 84:104819. https://doi.org/10.1016/j.amsu.2022.104819CrossRef

25.

Hosny AE, El-Bazza ZE, Ramadan MA et al (2021) Expression levels of pro-inflammatory interleukin-8 and certain antimicrobial peptides in concurrent with bacterial conjunctivitis. Int J Ophthalmol 14(5):666. https://doi.org/10.18240/ijo.2021.05.05CrossRefPubMedPubMedCentral

26.

National Health Portal India, Ministry of Health and Family Welfare (MoHFW), Government of India, Blepharitis2016. Available from: https://ncdc.mohfw.gov.in

27.

Nuhu A, Usman A (2021) Bacterial conjunctivitis among patients of different age groups attending some eye clinics in Sokoto, Nigeria. Hmlyn Jr Appl Med Scie Res 2(5):161–165. https://doi.org/10.47310/hjamsr.2021.v02i05.030CrossRef

28.

Joseph J, Karoliya R, Sheba E et al (2022) Trends in the microbiological spectrum of nonviral keratitis at a single tertiary care ophthalmic hospital in India—a review of 30 years. Cornea 13:10–97. https://doi.org/10.1097/ICO.0000000000003105CrossRef

29.

Chatterjee S, Agrawal D, Gomase SN et al (2022) Fluoroquinolone resistance in bacterial isolates from ocular infections: trend in antibiotic susceptibility patterns between 2005–2020. Indian J Ophthalmol 70(12):4391–4398. https://doi.org/10.4103/ijo.IJO_1033_22CrossRefPubMedPubMedCentral

30.

Lalitha P, Manoharan G, Karpagam R et al (2017) Trends in antibiotic resistance in bacterial keratitis isolates from South India. Br J Ophthalmol 101(2):108–113. https://doi.org/10.1136/bjophthalmol-2016-308487CrossRefPubMed

Title: Microbiological spectrum and antibiotic susceptibility patterns of non-viral conjunctivitis over 16 years at a tertiary eye care center in Southern India
Authors: Sreyasi Maiti
Jaishree Gandhi
Joveeta Joseph
Publication date: 03-07-2023
Publisher: Springer Netherlands
Keywords: Conjunctivitis
Antibiotic
Cefazolin
Published in: International Ophthalmology / Issue 10/2023
Print ISSN: 0165-5701
Electronic ISSN: 1573-2630
DOI: https://doi.org/10.1007/s10792-023-02781-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Microbiological spectrum and antibiotic susceptibility patterns of non-viral conjunctivitis over 16 years at a tertiary eye care center in Southern India

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 10/2023

Assessment interocular symmetry of peripapillary vessel density in young myopes with optical coherence tomographic angiography

Clinical characteristics of intermediate uveitis in adults according to criteria of the SUN working group

Is the ganglion cell layer thickness to macular thickness ratio a new biomarker for multiple sclerosis?

Public awareness about glaucoma, cataract, and diabetic retinopathy in Saudi Arabia: a systematic review and meta-analysis

Myopia control: short-term effect of 0.01% atropine vs. defocus incorporated multiple segment lenses—a retrospective study in European children

Three patterns for identifying the posterior plane of a lenticule during SMILE