Córdova JE, Tenorio G, García MM, Miño KH

Language: Spanish
References: 15
Page: 77-82
PDF size: 132.49 Kb.

ABSTRACT

Introduction: The conjunctival flora is the main intraocular contamination source in the cataract surgery due to bacteria entrance into the anterior chamber direct or indirectly by means of the surgical instruments or intraocular lenses during surgical manipulation. Endophthalmitis is an intraocular infection which may affect the eye seriously according to the virulence and the quantity of the bacteria can affect the eye and sometimes the total loss of the eye. Objective: To determine the patient’s conjunctival bacterial flora one week before the cataract surgery, with the purpose to foresight an endophthalmitis prophylactic protocol including preoperative most specific antibiotic. Method: It was done a prospective study with diagnosis methodology by means of bacteria cultures. They were included cataract patients from October 2007 to January 2008. By written previous consent it was done a conjunctival swab of the eye to be operated which was immediately swoon on blood and chocolate agar for 3 days and thioglycolate for 5 days. Those given positive culture were submitted to identification and sensibility to antibiotics (antibiograme). When it found bacterial growth in broth tioglycolate is enhanced isolation on MacConkey agar to investigate Gram negative rods and on blood agar for the isolation of that Gram positive and/or hemolytic bacteria. It was done the identification of the cultures to Staphylococcus besides the antibiograme on blood Mueller-Hilton with different antibiotics which were previously indicated. Results: Included 154 eyes of 134 patients. In 87 eyes (56.8%) crops were negative and 67 (43.2 %) were positive cultures between 1 to 5 days of positivity (1.41 days average). Out of the 67 microorganisms which were found 46 were S. epidermidis (68.6%), 6 were S. aureus (9%), 5 were Pseudomonas sp. And the others were Staphylococcus xylosus (n = 2), Proteus mirabilis (n = 2), Staphylococcus hominis (n = 2), Morganella morganii (n = 1), Citrobacter freundii cplx (n = 1), Acinobacter iwoffii (n = 1) and Streptococcus viridans (n = 1). For S. epidermidis sensitivity with ciprofloxacin and ofloxacin was 67% and 65% with resistance of 26% and 24% respectively. Staphylococcus epidermidis was sensitive to tobramycin by 85% and in 7% was resistant. For oxacillin and chloramphenicol sensitivity was 63% and a resistance of 37% and 30% respectively. Conclusions: We found that in patients they are going to cataract surgery and who have no clinically infection data, 43% had positive cultures in the swabs of the conjunctival sac. The main microorganism was Staphylococcus epidermidis in 68.6% of positive cultures in addition to a high prevalence of Gram-negative rods in the positive cultures (14.9%).

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