Abstract
Purpose: :
To report demographics, organism occurrence, and in–vitro resistance trends for patients presenting with bacterial conjunctivitis at Bascom Palmer Eye Institute in Miami, Florida from 1994 to 2003.
Methods: :
The microbiology records of all patients with bacterial conjunctivitis seeking treatment at Bascom Palmer Eye Institute from January 1, 1994 through December 31, 2003 were reviewed. Data on age, sex, culture–positive trends and in vitro susceptibility was collected. In vitro susceptibility data was generated using disc diffusion and minimal inhibitory concentrations.
Results: :
During the 10–year period, 1254 culture–positive pathogens were recovered from 2408 consecutive conjunctival swabs (52.1%). Culture–positive rate at baseline (1994–1998) was 55% and declined to 44% in the second five years. Male and female patients contributed equal percentages to the total isolates (50.0%) and females have a higher percentage of gram–positives than males (55.5%, p= 0.033). Gram–positive pathogens accounted for 52.2% of culture positive isolates. S. aureus was the most frequent isolate overall (37.6%) and in patients older than six years (47.8%). MRSA showed a significant increase in trend, 0% to 35.7% of S. aureus isolates (p<0.001). H. influenzae was the most frequent isolate recovered from patients under seven (59.8%, p= 0.0002). There was a three–fold increase in resistance of gram–positives to ciprofloxacin and oxacillin (p<0.001). Overall, 9.5% of gram–positive isolates were resistant to gentamicin. Trimethoprim/Sulfa showed a steady increase in resistance in gram–negative isolates (p=0.05).
Conclusions: :
S. aureus was the most common pathogen isolated. MRSA showed significant increasing prevalence. There was a two–fold and three–fold increase in resistance of gram–positive organisms to erythromycin and ciprofloxacin, respectively. Gentamicin showed good sensitivity toward gram–positive pathogens.
Keywords: conjunctivitis • bacterial disease • antibiotics/antifungals/antiparasitics