Microbiology of conjunctiva sac in cataract surgery patients

Session Details

Session Title: Endophthalmitis/Ocular Infections

Session Date/Time: Wednesday 09/09/2015 | 08:00-09:30

Paper Time: 08:00

Venue: Room 8

First Author: : A.Grzybowski POLAND

Co Author(s): :    M. Gaca-Wysocka                    

Abstract Details

Purpose:

Evaluation of conjunctival flora in cataract surgery patients.

Setting:

The use of topical antibiotics before and after cataract surgery remains controversial issue. Their effectiveness in the protection against postoperative endophthalmitis was not confirmed, and the overuse and misuse of antibiotics was shown to increase antibiotic resistance. Dept. of Ophthalmology, Poznan City Hospital, Poznan, Poland

Methods:

20 cataract patients not using antibiotics for at least 30 days were divided into two groups: 1. Antibiotic group (AG) - with topical antibiotics before surgery (10 patients) and 2. No-antibiotic group (NAG) - with no topical antibiotics (10 patients). In both groups microbiological culture from conjunctival sac to nutrient media was taken three times: a day before surgery, 1-3 hrs before surgery, and 3 hrs after surgery. In both groups prophylaxis protocol was based on ESCRS Guidelines (2013 update), including irrigation of conjunctival sac with 5% povidone-iodine and intracameral use of cefuroxime. All surgeries were not complicated.

Results:

In all three microbiological analyses there were no pathogens cultured in both groups in 50% of eyes. In AG in first culture there were 2 cases of Coagulase-negative Staphylococci (CNS) and 1 case of E. faecalis, which were not confirmed in subsequent cultures; in one eye there was saprophytic bacteria in 3rd culture. In NAG in 50% of eyes there were saprophytic bacteria in the 1st culture, which was confirmed in 30% in 2nd culture, and in 10% in 3rd culture. There was no case of TASS or endophthalmitis in each of groups.

Conclusions:

In both groups 50% of cultures before and after cataract surgery were negative. There were 3 pathogens cultured in AG, which were probably eliminated by antibiotic use. The number of saprophytic colonies decreased in larger proportion after antibiotic use (30% vs 10%), but after surgery there was no difference between both groups (10% vs 10%). The results indicate that although topical antibiotics decreased the number of pathogens and saprophytic bacteria in conjunctival sac, the postoperative flora in both groups was similar.

Financial Interest:

NONE