Elsevier

Ophthalmology

Volume 115, Issue 1, January 2008, Pages 51-56
Ophthalmology

Original article
Update on Bacterial Conjunctivitis in South Florida

https://doi.org/10.1016/j.ophtha.2007.03.076Get rights and content

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.

Design

Retrospective cross-sectional study.

Participants

Two thousand four hundred eight eyes.

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, gender, culture-positive trends, and in vitro susceptibility were collected. In vitro susceptibility data were generated using disc diffusion and minimal inhibitory concentrations.

Main Outcome Measures

Positive cultures by age, gender, and organism and in vitro resistance.

Results

During the 10-year period, 1254 culture-positive pathogens were recovered from 2408 consecutive conjunctival swabs (52.1%). The culture-positive rate from 1994 to1998 was 55% and declined to 44% in the second 5 years. Male and female patients contributed equal percentages to the total isolates (50.0%). Females had a higher percentage of gram-positives than males (55.5%; P = 0.033). Gram-positive pathogens accounted for 52.2% of culture positive isolates. Staphylococcus aureus was the most frequent isolate overall (37.6%) and in patients older than 6 years (47.8%). Methicillin-resistant S. aureus showed a significant increase in the 10-year period (4.4%–42.9% of S. aureus isolates; P = 0.001). Haemophilus influenzae was the most frequent isolate recovered from patients under 7 years old (59.8%; P = 0.0002). There was a 3-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

Staphylococcus aureus was the most common pathogen isolated. Methicillin-resistant S. aureus showed significant increasing prevalence. There were 2- and 3-fold increases in resistance of gram-positive organisms to erythromycin and ciprofloxacin, respectively. Gentamicin showed good sensitivity toward gram-positive pathogens.

Section snippets

Materials and Methods

A retrospective chart review of microbiology records was conducted for all patients who underwent a diagnostic conjunctival culture for suspect bacterial conjunctivitis by clinicians at Bascom Palmer Eye Institute from January 1, 1994 through December 31, 2003. Samples were collected according to standard Bascom Palmer Eye Institute protocol (Miller, unpublished data). The study was approved by the human subjects medical sciences subcommittee of the University of Miami School of Medicine

Results

There were a total of 1254 culture-positive isolates identified of 2408 consecutive conjunctival cultures evaluated for acute bacterial conjunctivitis between 1994 and 2003 at Bascom Palmer Eye Institute. The culture-positive rate for bacterial conjunctivitis was 52.1%.

Gram-positive pathogens accounted for 52.5% of isolates, versus 47.8% of gram-negative isolates. The percentage of gram-positive isolates ranged from 56.2% to 48.1% from the first 5 years to the second 5 years (P = 0.002). The

Discussion

The ratio of gram-positive to gram-negative isolates was consistent throughout the length of the study. Although the overall male-to-female ratio was 1:1, 49% of males had gram-positive organisms, compared with 56% of females (P = 0.031). This finding is not supported by previous literature and therefore may be spurious, making it unlikely to be highly significant. The most frequent isolates were S. aureus, H. influenzae, S. pneumoniae, P. aeruginosa, S. viridans, and P. mirabilis.

References (9)

There are more references available in the full text version of this article.

Cited by (99)

  • Gender and Ethnicity of Enrolled Participants in U.S. Food and Drug Administration (FDA) Clinical Trials for Approved Ophthalmological New Molecular Entities

    2018, Journal of the National Medical Association
    Citation Excerpt :

    The indications for the 9 approved NME trials over the last 10 years were: dry eye disease, open angle glaucoma/ocular hypertension, vitreomacular adhesion, neovascular age related macular degeneration, allergic conjunctivitis, pain and inflammation after ocular surgery, and bacterial conjunctivitis. Among those 7 indications, two are not known to have any interactions with race or gender: post-operative ocular pain/inflammation14 and bacterial conjunctivitis.15,16 It is known that gender and race play a role in dry eye disease.

View all citing articles on Scopus

Manuscript no. 2006-856.

Supported in part by a grant from Research to Prevent Blindness, New York, New York.

View full text