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A.B. Tarabishy, G.S. Hall, G.W. Procop, B.H. Jeng; Resistance Patterns of Bacterial Culture Isolates from Hospitalized Pediatric Patients with Conjunctivitis . Invest. Ophthalmol. Vis. Sci. 2006;47(13):1927.
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To determine the causative organisms of acute bacterial conjunctivitis in hospitalized pediatric patients at a tertiary care referral center.
A retrospective chart review was performed evaluating all pediatric patients hospitalized at the Cleveland Clinic Foundation from January 1, 1996 to November 30, 2004 who developed clinical signs of acute bacterial conjunctivitis and had culture–positive conjunctival swabs.
One hundred seven bacterial isolates were cultured from the eyes of 59 patients. A single organism was found in 27 (45.8%) patients. The most common organism was coagulase–negative staphylococcus (CNS), found in 59.3% (35 of 59) of patients. Viridans group streptococci and Staphylococcus aureus were found in 47.5% (28 of 59) and 20.3% (12 of 59) of patients, respectively. Less common organisms included Haemophilus influenzae (17.0%), Pseudomonas aeruginosa (8.5%), and Escherichia coli (6.8%). Among the 42 isolates of CNS identified, 26 were tested for antimicrobial susceptibility, and 65.3% (17 of 26) were methicillin–resistant (MRSE). Of 17 isolates of MRSE that were tested, 23.5% (4 of 17) were also fluoroquinolone–resistant. Similarly, 13 of 13 isolates of Staphylococcus aureus were tested for susceptibility, and 30.8% (4 of 13) were methicillin–resistant while 7.7% (1 of 13) were fluoroquinolone–resistant.
The distribution of bacterial organisms recovered from patients with acute conjunctivitis in our hospitalized patients differs from that of previous reports of pediatric patients who present with acute bacterial conjunctivitis in an outpatient setting. There seems to be a high rate of methicillin–resistance among the CNS and Staphylococcus aureus isolates in our hospital setting. There also appears to be some fluoroquinolone–resistance among MRSE and MRSA isolates. As opposed to empiric treatment of pediatric acute bacterial conjunctivitis in an outpatient setting, in an inpatient setting where causative organisms may be different and antibiotic resistance may be higher, conjunctival swabbing for culture and susceptibilities may be warranted.
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