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Open Access Highly Accessed Research article

External ocular surface bacterial isolates and their antimicrobial susceptibility patterns among pre-operative cataract patients at Mulago National Hospital in Kampala, Uganda

Barnabas Mshangila12, Musana Paddy1, Henry Kajumbula3, Charles Ateenyi-Agaba1, Binta Kahwa1 and Jeremiah Seni34*

Author Affiliations

1 Department of Ophthalmology, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda

2 Mbeya Referral Hospital, P.O. Box 419, Mbeya, Tanzania

3 Department of Medical Microbiology, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda

4 Department of Microbiology and Immunology, Catholic University of Health and Allied Sciences Bugando, P.O. Box 1464, Mwanza, Tanzania

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BMC Ophthalmology 2013, 13:71  doi:10.1186/1471-2415-13-71

Published: 15 November 2013

Abstract

Background

Endophthalmitis is a severe complication of cataract surgery which leads to high ocular morbidity and visual loss even with antibiotic treatment. Bacterial ocular floras are the implicated causative agents. This study was undertaken to evaluate the external ocular surface bacterial isolates and their antimicrobial susceptibility patterns among pre-operative cataract patients at Mulago National Hospital.

Methods

This cross sectional study enrolled consecutively 131 patients scheduled for routine cataract surgery in the Department of Ophthalmology at Mulago National Hospital in Kampala, Uganda. Eyelid margin and conjunctival swabs were collected and processed using standard microbiological procedures to identify bacterial isolates and their respective antimicrobial susceptibility patterns.

Results

Of 131 patients involved (mean age 63.3 ± 14.5 years), 54.2% (71/131) were females. The eyelid margin and conjunctival samples were culture positive in 59.5% (78/138) and 45.8% (60/138) respectively. The most common organisms identified were Coagulase-negative Staphylococci (CoNS) [65.9% (91/138)] and Staphylococcus aureus [21.0% (29/138)]. CoNS showed the highest resistance to tetracycline (58.2%, 53/91) and erythromycin (38.5%, 35/91), whereas in S. aureus the resistance to tetracycline and erythromycin were 55.2% (16/29) and 31.0% (9/29) respectively. Methicillin resistant CoNS (MRS) and Methicillin resistance S. aureus (MRSA) were 31.9% (29/91) and 27.6% (8/29) respectively. There were low resistance rates for CoNS, S. aureus and other bacterial isolates to ciprofloxacin (11.1%-24.2%), gentamicin (5.6-31.0%), tobramycin (17.2% -25.3%) and vancomycin (0.0%).

Conclusion

CoNS and S. aureus are the most common bacterial isolates found on the external ocular surface of the pre-operative cataract patients. Ciprofloxacin, gentamicin, tobramycin and vancomycin showed the lowest resistance rates to all bacterial isolates, therefore may be used to reduce bacteria load in the conjunctiva sac among cataract patients prior to surgery.

Keywords:
Antimicrobial susceptibility; Cataract patients; Uganda