Importance of Conjunctival Swab Culture and Sensitivity Test Before Cataract Surgery

Abstract

Purpose: To determine the spectrum of infectious-agent from conjunctival swab and antibiotic susceptibility. To observe the necessity of conjunctival swab culture and sensitivity prior to intraocular surgery as a preventive measure against post operative endophthalmitis in the socio-economic perspective of our country.

Method: A retrospective review of microbiological records of conjunctival swab was done for 22 months (From August 2000 to May 2002) in BSMMU, Dhaka, Bangladesh. We selected the culture positive cases for our study. Antibiotic susceptibility of these isolates was determined for fourteen ocular and systemic antibiotics.

Result: Among 209 attendant cases, 57 were culture positive. All of them were gram positive bacteria. Most of them were staphylococcus epidermis 47 (82.5%) others were staphylococcus aureus 5 (8.77%); streptococcus viridans 5 (8.77%). There was specific age variation also. All organisms were 100% sensitive to Chloramphenicol. Staphylococcus epidermidis, treptococcus viridans were 100% sensitive to Gentamycin and Ciprofloxacin, while staphylococcus aureus show 80% sensitivity. Organisms were least sensitive to Neosporin.

Conclusion: Commonest isolated organism from conjunctival swab is staphylococcus epidermidis (82.5%). All the organism shows full range of sensitivity and no resistance to chloramphenicol; also maximum sensitivity and no resistance to Gentamycin, Ciprofloxacin in our study group and from this it can be conclude that instead of doing random C/S for conjunctival swab we can give prophylactic broad spectrum antibiotic eye drop to starilize conjunctival sac before surgery