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Conjunctival bacterial flora and antimicrobial susceptibility in bacterial pathogens isolated prior to cataract surgery

  • Clinical Investigation
  • Published:
Japanese Journal of Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

To optimize prophylactic antibiotic administration, antibiotic susceptibility before cataract surgery was investigated using ocular bacteria isolated preoperatively.

Design

Retrospective cross-sectional study.

Methods

In 204 eyes of 102 patients who underwent routine bilateral cataract surgery, conjunctival sac scrapings were collected 1–2 weeks before surgery. A total of 192 major pathogens among the 470 isolated bacteria were subjected to susceptibility testing. The major pathogens included Staphylococcus aureus, Staphylococcus epidermidis, coagulase-negative staphylococci (CNS) other than S. epidermidis, Enterococcus faecalis, and Streptococcus spp. The following antibiotics were tested: cefmenoxime (CMX), ceftazidime (CAZ), tobramycin (TOB), vancomycin (VAN), erythromycin (EM), moxifloxacin (MFLX), gatifloxacin (GFLX), levofloxacin (LVFX), chloramphenicol (CP), and imipenem (IP).

Results

The proportions of isolates with minimum inhibitory concentration (MIC) of S. epidermidis (N = 82), exceeding 4 μg/ml were high for CAZ (95.1%), EM (32.9%), LVFX (39.0%), and CP (82.9%).

Susceptible (S) proportion was high for CMX (98.8%), VAN (100%), CP (93.9%), and IP (97.6%) but relatively low for MFLX (59.8%), GFLX (54.9%), and LVFX (54.9%). The MIC90 values were high for CMX (16 μg/ml), CAZ (64 μg/ml), TOB (32 μg/ml), EM (128 μg/ml), LVFX (16 μg/ml), and CP (8 μg/ml). The MIC of quinolonesof

pathogenic bacteria other than S.epidermidis (N = 108), exceeded 4 μg/ml for 11 isolates, including two Methicillin-resistant Staphylococcus aureus.

Conclusions

The increase in resistance of resident bacteria present in the conjunctival sac to antibiotics indicates that systemic and topical antibiotics are no longer effective, especially against external organisms affecting the eye.

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Abbreviations

MIC:

Minimum inhibitory concentration

CNS:

Staphylococcus epidermidis, Coagulase-negative staphylococci

CLSI:

Clinical and Laboratory Standards Institute

CMX:

Cefmenoxime

CAZ:

Ceftazidime

TOB:

Tobramycin

VAN:

Vancomycin

EM:

Erythromycin

MFLX:

Moxifloxacin

GFLX:

Gatifloxacin

LVFX:

Levofloxacin

CP:

Chloramphenicol

IP:

Imipenem

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Acknowledgements

K. Matsuura, Grants-in-Aid for Scientific Research S.S., 15K20261 (Ministry of Education, Culture, Sports, Science and Technology of Japan); Y. Inoue, Lecture fee (Japanese Ophthalmological Society).

Author information

Authors and Affiliations

  1. Nojima Hospital, 2714-1, Sesaki-machi, Kurayoshi, Tottori, 682-0863, Japan

    Kazuki Matsuura

  2. Tottori University, 36-1, Nishi-cho, Yonago, Tottori, 683-8504, Japan

    Dai Miyazaki, Shin-ichi Sasaki, Yoshitsugu Inoue & Yumiko Shimizu

  3. The Research Foundation for Microbial Diseases of Osaka University, 3-1, Yamadaoka, Suita, Osaka, 565-0871, Japan

    Yumi Sasaki

Authors
  1. Kazuki Matsuura
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  2. Dai Miyazaki
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  3. Shin-ichi Sasaki
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  4. Yoshitsugu Inoue
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  6. Yumiko Shimizu
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Contributions

All authors were responsible for the design of the study. KM and YS collected the data. All authors participated in the analysis and interpretation of data. KM and YI drafted and critically reviewed the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Kazuki Matsuura.

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Conflicts of interest

K. Matsuura, None; D. Miyazaki, None; S. Sasaki, None; Y. Inoue, Consultant fee (Senju), Grant (Santen, Alcon); Y. Sasaki, None; Y. Shimizu, None.

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Corresponding Author: Kazuki Matsuura

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Matsuura, K., Miyazaki, D., Sasaki, Si. et al. Conjunctival bacterial flora and antimicrobial susceptibility in bacterial pathogens isolated prior to cataract surgery. Jpn J Ophthalmol 64, 423–428 (2020). https://doi.org/10.1007/s10384-020-00746-z

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  • DOI: https://doi.org/10.1007/s10384-020-00746-z

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