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Bacterial isolates in traumatic globe ruptured patients in a peripheral tertiary medical college and hospital

Asim Kumar Dey, Saumen Kumar Chaudhuri, Subhasis Jana, Purban Ganguly, Sumi Ghorai, Sayantan Mondal.


Abstract

Background: Ocular trauma can lead to access of bacteria to the intra ocular contents. So the information of the bacterial contaminants is crucial to institute empirical antibiotic therapy to prevent the development of endophthalmitis.

Aims & Objectives: To isolate the bacterial contamination following traumatic globe ruptured patients in a peripheral tertiary medical college and hospital.

Materials and Methods: This prospective study was conducted in the department of Ophthalmology, Burdwan Medical College, over a period of one year from April 2013- March 2014. A detailed history was taken and ophthalmological workup was done for each open globe injury cases. At the time of repair, we took three samples for bacteriological culture. Those samples were collected as conjunctival swab from inferior fornix, aqueous sample, and vitreous tap respectively. The collected samples were labeled properly and immediately sent to the department of microbiology for bacteriological culture and sensitivity. The culture report was studied and recorded.

Results: The study included 75 cases, of which, 57were males, and 18 were females. Age of the study population was ranging from 18 – 54 years. Fifty seven (77.33%) study population belonged to rural areas, and eighteen (24%) were of urban area. Most common etiologic agent responsible for traumatic rupture of globe was stone chip followed by road traffic accident. Bacteria were isolated from 50 (66.66%) of the 75 eyes studied. Of these 50 eyes, a single isolate was detected in 39 (78%) eyes, while there were two isolates in 7 (14%) eyes, three and or more isolates in 4 (8%) eyes. In more detail, there were 33 strains of Gram-positive cocci, accounting for 66.0% of all isolates, of which most common was staphylococcus epidermidis (46%). Among 8 Gram-positive bacilli isolates (16%), all were of the genus Corynebacterium. There were 9 (18%) Gram-negative bacillary isolates, including 3 (6%) Escherichia coli; 2 (4%) isolates of Pseudomonas aeruginosa, and one isolate (2%) each of Proteus vulgaris, Enterobacter aerogenes, Klebsiella, and Haemophilus influenzae.

Conclusion: Isolation of bacteria from eyes with open globe injuries, and their subsequent antibiotic sensitivity pattern, provides an insight into selection of appropriate prophylactic drugs for prevention of development of endophthalmitis.

Key words: Bacterial Isolates; Traumatic Globe Rupture; Endophthalmitis






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