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Antibiotic susceptibility of conjunctival bacterial isolates from refractive surgery patients

 Jae Lim Chung  ;  Kyoung Yul Seo  ;  Dong Eun Yong  ;  Francis S. Mah  ;  Tae-im Kim  ;  Eung Kweon Kim  ;  Jin Kook Kim 
 OPHTHALMOLOGY, Vol.116(6) : 1067-1074, 2009 
Journal Title
Issue Date
Adult ; Anti-Bacterial Agents/pharmacology* ; Bacteriological Techniques ; Conjunctiva/microbiology* ; Female ; Gram-Negative Bacteria/drug effects* ; Gram-Negative Bacteria/isolation & purification ; Gram-Positive Bacteria/drug effects* ; Gram-Positive Bacteria/isolation & purification ; Humans ; Keratectomy, Subepithelial, Laser-Assisted ; Keratomileusis, Laser In Situ ; Male ; Microbial Sensitivity Tests* ; Middle Aged ; Refractive Surgical Procedures* ; Young Adult
PURPOSE: To determine the in vitro antibiotic susceptibility patterns of conjunctival bacterial flora isolated before surgery from patients undergoing refractive surgery. DESIGN: In vitro laboratory investigation. PARTICIPANTS: One hundred five eyes from 105 patients scheduled for refractive surgery at Balgensesang Ophthalmology Clinic between September 2005 and January 2006 were studied. Among 105 patients, 71 (67.6%) underwent LASIK using a femtosecond laser, 24 (22.9%) underwent LASIK using an automated microkeratome, 8 (7.6%) underwent LASEK, and 2 (1.9%) patients underwent phakic intraocular lens implantation. METHODS: Preoperative conjunctival swab samples were inoculated directly in culture media at the bedside before topical anesthetic or antibiotic application. Blood agar, chocolate agar, thioglycolate broth, Sabouraud dextrose agar, and Ogawa media were used for bacterial, fungal, and mycobacterial cultures. MAIN OUTCOME MEASURES: Minimum inhibitory concentrations (MICs) of ofloxacin (OFX), levofloxacin (LEV), gatifloxacin (GAT), moxifloxacin (MOX), gemifloxacin (GEM), and other commonly used antibiotics were determined using an E test. RESULTS: From 105 patients, 73 (85%) coagulase-negative staphylococci (CNS), 2 (2.3%) Staphylococcus aureus, 1 (1.2%) Streptococcus pneumoniae, and 5 (4.8%) gram-negative bacilli were isolated. No fungi or mycobacteria were isolated. The MIC that would inhibit the growth of 90% of the tested bacterial isolates (MIC(90)) of OFX, LEV, GAT, MOX, and GEM for methicillin-susceptible CNS (n = 46) were 0.5 microg/ml, 0.19 microg/ml, 0.094 microg/ml, 0.047 microg/ml, and 0.023 microg/ml, respectively. The MIC(90) values for methicillin-resistant CNS (n = 27) were 32 microg/ml, 4 microg/ml, 1 microg/ml, 0.5 microg/ml, and 0.25 microg/ml, respectively (P<0.001). CONCLUSIONS: The most effective against conjunctival bacteria isolated from refractive surgery patients were GEM, MOX, and GAT; however, resistance to earlier-generation fluoroquinolones (OFX and LEV) is increasing among methicillin-resistant CNS. It may be a therapeutic option to use newer fluoroquinolones in patients undergoing refractive eye surgery to reduce such infections as methicillin-resistant CNS. FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article
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1. College of Medicine (의과대학) > Dept. of Ophthalmology (안과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Laboratory Medicine (진단검사의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Eung Kweon(김응권) ORCID logo https://orcid.org/0000-0002-1453-8042
Kim, Tae Im(김태임) ORCID logo https://orcid.org/0000-0001-6414-3842
Seo, Kyuong Yul(서경률) ORCID logo https://orcid.org/0000-0002-9855-1980
Yong, Dong Eun(용동은) ORCID logo https://orcid.org/0000-0002-1225-8477
Chung, Jae Lim(정재림)
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