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

Int Ophthalmol. 2023 Oct;43(10):3717-3724. doi: 10.1007/s10792-023-02781-4. Epub 2023 Jul 3.

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.

Keywords: Antibiotic susceptibility; Conjunctivitis; Keratitis; Microbiology; Trends.

MeSH terms

  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use
  • Conjunctiva
  • Conjunctivitis* / drug therapy
  • Eye Infections, Bacterial* / drug therapy
  • Eye Infections, Bacterial* / epidemiology
  • Eye Infections, Bacterial* / microbiology
  • Fungi
  • Gram-Negative Bacteria
  • Gram-Positive Bacteria
  • Humans
  • India / epidemiology
  • Microbial Sensitivity Tests
  • Retrospective Studies
  • Staphylococcus aureus

Substances

  • Anti-Bacterial Agents