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CD Siapco, RP Kowalski, FS Mah; The Bacterial Flora of the Conjunctiva in Patients With Non-Bacterial Keratitis and Conjunctivitis . Invest. Ophthalmol. Vis. Sci. 2002;43(13):1603.
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Purpose: There has been discrepancy in reporting the bacterial flora of the conjunctiva in normal people and those with non-bacterial eye disease. In this original study, we examined the bacterial flora of the conjunctiva in patients with non-bacterial keratitis and conjunctivitis to determine whether added prophylaxis is necessary for surgery in these patients. Methods: The laboratory reports of patients with non-bacterial keratitis and conjunctivitis were reviewed retrospectively for patients' age, sex, clinical diagnosis, and for the isolation of bacteria from the conjunctiva (Univ of Pittsburgh IRB# 0110102). The bacteria were identified and quantified as 1-3 colonies, 1+ (4-10 colonies), 2+ (11-20 colonies), 3+ (20-near confluent), and 4+ (confluent growth). Patients with an indication of antibiotic treatment were excluded. Cultures were not obtained from both eyes in all patients. Results: We reviewed the reports of 32 patients with non-bacterial conjunctivitis. The mean age was 54 years with 10 (31%) females and 22 (69%) males. Coagulase-negative Staphylococcus, diphtheroids, and Streptococcus viridans were the predominant bacteria. From the conjunctiva, no growth was present in 27% (16/59), 1-3 colonies in 30% (18/59), 1+ in 25% (15/59), 2+ in 13% (8/59), and 3+ in 3% (2/59). Sixty-three patients were reviewed for non-bacterial keratitis. The mean age was 38 years with 35 (56%) female and 28 (44%) male. The bacteria was similar to the conjunctivitis group. From the conjunctiva, no growth was present in 47% (35/75), 1-3 colonies in 19% (14/75), 1+ in 27% (20/75), 2+ in 4% (3/75), and 3+ in 4% (3/75). Conclusion: The bacterial flora of the conjunctiva and eyelid in patients presenting with non-bacterial keratitis and conjunctivitis in this report is similar to the reports in the literature concerning the healthy conjunctiva. In general, there was "no" or sparse growth isolated from the conjunctiva. Added surgical prophylaxis in these patients may not be warranted.
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