Bacteria isolates in external ocular and periocular infections and antimicrobial treatment patterns among Ghanaian ophthalmic patients: a multicenter study

Abstract

Purpose : Given the surge in global antimicrobial resistance infections, insight into the bacteria etiology is essential in the choice of antibiotic therapy among ophthalmic clinicians in their routine management of eye infections. Considering the paucity of data from Ghana, this study investigated the bacteria etiology of external ocular and periocular infections, and antimicrobial treatment patterns among ophthalmic patients in Ghana.

Methods : The multicenter cross-sectional study enrolled patients from three hospital facilities in Ghana. One hundred and fourteen eligible subjects were enrolled and underwent comprehensive ophthalmic assessments. Clinical profile and demographic characteristics were collated with a pretested structured questionnaire. Ocular specimens including conjunctival swabs and corneal scrapes were obtained from patients' eyes and subjected to microbial analyses. Bacterial pathogens were isolated and characterized by differential media, colony morphology, gram reactions under light microscopy, and biochemical testing. All procedures were performed under aseptic conditions.

Results : About 95% of ocular samples were positive for bacteria culture. The proportion of Gram-negative bacteria was 58.2%, and the predominantly isolated bacteria species were Pseudomonas aeruginosa 38.8% and Staphylococcus aureus 27.6%. Pseudomonas aeruginosa was mostly implicated in cases of conjunctivitis and keratitis and with a proportionate distribution of 40.0% versus 75.0%, respectively. The routinely used antimicrobial therapy in the clinical management of eye infections was polymyxin B 41.2%, neomycin 35.1%, and ciprofloxacin 31.6%. Participants' demographic and clinical characteristics were not associated (p > 0.05, for all) with the presence of positive bacteria culture.

Conclusions : Our results demonstrate a markedly high burden of bacteria ocular infections with variations in etiology. Bacterial infection-control and antimicrobial agent management programs should be urgently instituted to prevent the emergence of potential resistant infections.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.