Bacterial Etiology and Antibiotic Susceptibility of Conjunctivitis Patients' Isolates in Kashan, Iran

Authors
Mahdi Shaeri 1
Ali Nazari-Alam 2
Hadis Fathizadeh 3
Hosein Akbari 4
Mansooreh Mansoori 3
Ali Aghajani 5
1 Department of Ophthalmology, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran
2 Department of Microbiology and Immunology, Faculty of Medicine; Physiology Research Center, Institute for Basic Sciences, Kashan University of Medical Sciences, Kashan, Iran
3 Department of Microbiology and Immunology, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran
4 Department of Epidemiology and Biostatistics, School of Health, Kashan University of Medical Sciences, Kashan, Iran
5 Department of Parasitology and Mycology, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran
Abstract
Background: Conjunctivitis is a very common ocular disease, which can be caused by a wide variety of microorganisms. This study was aimed to assess the bacterial etiology and antibiotic susceptibility of conjunctivitis patients' isolates from Central Iran. Materials and Methods: This study was performed in 180 patients referred to the Department of Ophthalmology in Kashan University with symptoms of conjunctivitis from July 2017 to December 2017. To detect of different bacteria, Gram staining, morphological characterization, pigment production, biochemical characteristics, coagulase test, optochin and PYR tests, oxidase test, and culture on specific media were used. Antibiotic susceptibility of the bacteria isolated was done using the Kirby–Bauer method. Methicillin resistance in staphylococci isolated from the patients was identified using polymerase chain reaction technique. Results: Of the 195 bacteria isolated, about 81.5% were Staphylococcus epidermidis and Staphylococcus aureus and the remaining 19.5% included other species. In the present study, Pseudomonas aeruginosa was most resistant to ampicillin. In the case of S. epidermidis and S. aureus, the highest resistance was observed against erythromycin and the least resistance was against rifampicin and linezolid. Conclusion: In this study, S. aureus and S. epidermidis are the most common causes of conjunctivitis in all age groups, however, this condition decreases with age and is also influenced by other factors such as season and weather conditions. The results of this study can be helpful in planning more prudent treatment strategies for patients with conjunctivitis in Kashan.

Keywords

1.
Vaughan D. Conjunctivitis due to infectious diseases. In: General Ophthalmology. 16th ed. USA: McGraw Hill; 2003. p. 101-15.  Back to cited text no. 1
    
2.
Adebayo A, Parikh JG, McCormick SA, Shah MK, Huerto RS, Yu G, et al. Shifting trends in in vitro antibiotic susceptibilities for common bacterial conjunctival isolates in the last decade at the New York Eye and Ear Infirmary. Graefes Arch Clin Exp Ophthalmol 2011;249:111-9.  Back to cited text no. 2
    
3.
Alfonso SA, Fawley JD, Alexa Lu X. Conjunctivitis. Prim Care 2015;42:325-45.  Back to cited text no. 3
    
4.
Morrow GL, Abbott RL. Conjunctivitis. Am Fam Physician 1998;57:735-46.  Back to cited text no. 4
    
5.
Li W, Nie A, Li Q, Xie N, Ling Y. Establishment of rapid diagnostic method for the identification of Staphylococcus aureus in bacterial conjunctivitis. Materials Exp 2019;9:484-91.  Back to cited text no. 5
    
6.
Buznach N, Dagan R, Greenberg D. Clinical and bacterial characteristics of acute bacterial conjunctivitis in children in the antibiotic resistance era. Pediatr Infect Dis J 2005;24:823-8.  Back to cited text no. 6
    
7.
Ubani UA. Bacteriology of external ocular infections in Aba, South Eastern Nigeria. Clin Exp Optom 2009;92:482-9.  Back to cited text no. 7
    
8.
Bertino JS Jr. Impact of antibiotic resistance in the management of ocular infections: The role of current and future antibiotics. Clin Ophthalmol 2009;3:507-21.  Back to cited text no. 8
    
9.
Bharathi MJ, Ramakrishnan R, Shivakumar C, Meenakshi R, Lionalraj D. Etiology and antibacterial susceptibility pattern of community-acquired bacterial ocular infections in a tertiary eye care hospital in south India. Indian J Ophthalmol 2010;58:497-507.  Back to cited text no. 9
[PUBMED]  [Full text]  
10.
Anagaw B, Biadglegne F, Belyhun Y, Anagaw B, Mulu A. Bacteriology of ocular infections and antibiotic susceptibility pattern in Gondar University Hospital, North West Ethiopia. Ethiop Med J 2011;49:117-23.  Back to cited text no. 10
    
11.
Kondo Y, Ito T, Ma XX, Watanabe S, Kreiswirth BN, Etienne J, et al. Combination of multiplex PCRs for staphylococcal cassette chromosome mec type assignment: Rapid identification system for mec, ccr, and major differences in junkyard regions. Antimicrob Agents Chemother 2007;51:264-74.  Back to cited text no. 11
    
12.
Høvding G. Acute bacterial conjunctivitis. Acta Ophthalmol 2008;86:5-17.  Back to cited text no. 12
    
13.
Sambursky RP, Fram N, Cohen EJ. The prevalence of adenoviral conjunctivitis at the Wills Eye Hospital Emergency Room. Optometry 2007;78:236-9.  Back to cited text no. 13
    
14.
Cavuoto K, Zutshi D, Karp CL, Miller D, Feuer W. Update on bacterial conjunctivitis in South Florida. Ophthalmology 2008;115:51-6.  Back to cited text no. 14
    
15.
Okesola AO, Salako AO. Microbiological profile of bacterial conjunctivitis in Ibadan, Nigeria. Ann Ib Postgrad Med 2010;8:20-4.  Back to cited text no. 15
    
16.
Zaidi TS, Zaidi T, Pier GB. Antibodies to conserved surface polysaccharides protect mice against bacterial conjunctivitis. Invest Ophthalmol Vis Sci 2018;59:2512-9.  Back to cited text no. 16
    
17.
Vichyanond P, Brown Q, Jackson D. Acute bacterial conjunctivitis. Bacteriology and clinical implications. Clin Pediatr (Phila) 1986;25:506-9.  Back to cited text no. 17
    
18.
Patel PB, Diaz MC, Bennett JE, Attia MW. Clinical features of bacterial conjunctivitis in children. Acad Emerg Med 2007;14:1-5.  Back to cited text no. 18
    
19.
Shanmuganathan VA, Armstrong M, Buller A, Tullo AB. External ocular infections due to methicillin-resistant Staphylococcus aureus (MRSA). Eye (Lond) 2005;19:284-91.  Back to cited text no. 19
    
20.
Blomquist PH. Methicillin-resistant Staphylococcus aureus infections of the eye and orbit (an American Ophthalmological Society thesis). Trans Am Ophthalmol Soc 2006;104:322-45.  Back to cited text no. 20
    
21.
Fallah F, Mirdehghan SA, Faramarzi N. Bacterial agents in patients with conjunctivitis in Labbafinejad hospital in 2006. Res Med 2009;33:112-6.  Back to cited text no. 21
    
22.
Ghasemi H, Borna H, Jalali Nadooshan MR. Assessment of common pathogens in bacterial conjunctivitis and antibiotic sensitivity in Shaheed Mostafa Khomeini Hospital. KAUMS J (FEYZ) 2006;10:15-20.  Back to cited text no. 22
    
23.
Shahriari H, Ghavimi K, Qureshi M. Bacterial conjunctivitis in Zahedan. Med J Islamic Rep Iran 1996;10:145-8.  Back to cited text no. 23
    
24.
Akter L, Salam M, Hasan B, Begum N, Ahmed I. Etiological agents of suppurative corneal ulcer: Study of 56 cases. Bangladesh J Med Microbiol 2009;3:33-6.  Back to cited text no. 24
    
25.
Tarabishy AB, Hall GS, Procop GW, Jeng BH. Bacterial culture isolates from hospitalized pediatric patients with conjunctivitis. Am J Ophthalmol 2006;142:678-80.  Back to cited text no. 25
    
26.
Aoki K, Tagawa Y. A twenty-one year surveillance of adenoviral conjunctivitis in Sapporo, Japan. Int Ophthalmol Clin 2002;42:49-54.  Back to cited text no. 26
    
27.
Sohrabi N, Tebianian M, Moeini H. Analyzing bacterial agents of keratoconjunctivitis in patients referred to Ophthalmology Ward of Feiz Hospital in Isfahan. J Fasa Univ Med Sci 2011;1:37-42.  Back to cited text no. 27
    
28.
Bhattacharyya A, Sarma P, Sarma B, Kumar S, Gogoi T, Kaur H, et al. Bacteriological pattern and their correlation with complications in culture positive cases of acute bacterial conjunctivitis in a tertiary care hospital of upper Assam: A cross sectional study. Medicine (Baltimore) 2020;99:e18570.  Back to cited text no. 28
    
29.
Kowalski RP, Karenchak LM, Romanowski EG. Infectious disease: Changing antibiotic susceptibility. Ophthalmol Clin North Am 2003;16:1-9.  Back to cited text no. 29
    
30.
de Kaspar HM, Koss MJ, He L, Blumenkranz MS, Ta CN. Antibiotic susceptibility of preoperative normal conjunctival bacteria. Am J Ophthalmol 2005;139:730-3.  Back to cited text no. 30
    
31.
Control CF. Prevention. Staphylococcus aureus resistant to vancomycin-United States, 2002. MMWR Morbidity Mortality Weekly Rep 2002;51:565.  Back to cited text no. 31
    
Advanced Biomedical Research
Volume 2020, september
September 2020
Pages 1-7