Article Text
Abstract
Objective To investigate the conjunctival and nasal flora and the antibiotic susceptibility profiles of isolates from patients undergoing cataract surgery.
Design Observational and cross-sectional study.
Setting A single-centre study in Taiwan.
Participants 128 consecutive patients precataract surgery.
Primary and secondary outcome measures methods Conjunctival and nasal cultures were prospectively obtained from 128 patients on the day of cataract surgery before instillation of ophthalmic solutions in our hospital. Isolates and antibiotic susceptibility profiles were identified through standard microbiological techniques. Participants were asked to complete a questionnaire on healthcare-associated factors.
Results The positive culture rate from conjunctiva was 26.6%, yielding 84 isolates. Coagulase-negative Staphylococci were the most commonly isolated organisms (45.2%), and 35% of staphylococcal isolates were methicillin-resistant. Among staphylococcal isolates, all were susceptible to vancomycin, and 75%–82.5% were susceptible to fluoroquinolones. Methicillin-resistant isolates were significantly less susceptible than their methicillin-sensitive counterparts to tobramycin, the most commonly used prophylactic antibiotic in our hospital (28.6% vs 69.2%; p=0.005). The positive culture rate from nares for Staphylococcus aureus was 21.9%, and six isolates were methicillin-resistant. No subjects had S. aureus colonisation on conjunctiva and nares simultaneously. There were no associated risk factors for colonisation of methicillin-resistant Staphylococci.
Conclusion The most common conjunctival bacterial isolate of patients undergoing cataract surgery was coagulase-negative Staphylococci in Taiwan. Because of predominant antibiotic preferences and selective antibiotic pressures, Staphylococci were more susceptible to fluoroquinolones but less to tobramycin than in other reports. Additionally, methicillin-resistant Staphylococci exhibited co-resistance to tobramycin but not to fluoroquinolones.
- Epidemiology
- Infection Control
- Cataract And Refractive Surgery
- Corneal And External Diseases
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Footnotes
Contributors CHH: responsible for conception and design of the study. CHHsi and CHH: responsible for provision of patients. YHL and YCK: involved in collection and statistical analysis of data. LYH was involved in writing of the manuscript. YCH and CHH: responsible for critical revision of the manuscript. YCH, CJC, JCS, PHH and CHH: responsible for obtaining funding for the study. All authors: approved the final draft of the manuscript.
Funding This work was supported by National Science Council, Taiwan (NSC103-2314-B-182A-043-MY2, NMRPG3D6071) and Chang Gung Memorial Hospital, Taiwan (CMRPG3F0111). The sponsor or funding organization had no role in the design or conduct of this research.
Competing interests None declared.
Ethics approval The Institutional Review Board of Chang Gung Memorial Hospital.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement No additional data are available.