RESEARCH - Bacteriologic profile of the conjunctiva in patients with dry eye

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Am J Ophthalmol. 2008 Nov;146(5):729-34. Epub 2008 Jul 30.

Bacteriologic profile of the conjunctiva in the patients with dry eye.

Hori Y, Maeda N, Sakamoto M, Koh S, Inoue T, Tano Y.

Department of Ophthalmology, Osaka University Medical School, Suita, Japan.

PURPOSE: To assess the conjunctival bacterial profiles in dry eye and

their fluoroquinolone susceptibility patterns.

DESIGN: Prospective, observational study.

METHODS: Sixty-seven female patients with dry eye (29 with Sjögren

syndrome and 38 without Sjögren syndrome) who received artificial

tears were enrolled at Osaka University Hospital in Japan.

Twenty-three patients received additional topical steroids. Twenty-six

puncta were occluded with plugs. Cultures were obtained with

conjunctival swabs at the right eye of the subjects. The minimum

inhibitory concentrations of isolated strains were determined for the

fluoroquinolones (levofloxacin and gatifloxacin). The profiles of

conjunctival bacteria of patients with dry eye were compared with

those obtained before surgery from 56 female control patients.

RESULTS: Eighty-eight strains were isolated (48 strains of

Propionibacterium acnes, 26 coagulase-negative Staphylococcus [CNS]

species, six Staphylococcus aureus strains, and eight others). Of the

26 CNS strains, 17 (65.4%) were fluoroquinolone resistant, including

four (33.3%) of 12 methicillin-sensitive CNS and 13 (92.9%) of 14

methicillin-resistant CNS. All methicillin-sensitive S. aureus strains

and P. acnes strains were sensitive to fluoroquinolones; one

methicillin-resistant S. aureus strain was resistant. There was no

significant difference in the conjunctival isolation rates between

patients with dry eye and controls. However, the dry eye group had a

significantly higher incidence of fluoroquinolone-resistant

methicillin-sensitive CNS and of fluoroquinolone-resistant

methicillin-resistant CNS than controls (P = .018 and P = .024,

respectively). There were no significant differences in bacteria

isolated between subgroups with or without punctal plugs and with or

without topical steroids.

CONCLUSIONS: Patients with dry eye are more likely to have

fluoroquinolone-resistant conjunctival bacteria than controls. These

results may help prevent infectious keratoconjunctivitis in patients

with dry eye.

PMID: 18672220

http://www.ncbi.nlm.nih.gov/pubmed/18672220

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