A rapid assay of granulocytic esterase in the discharge of conjunctival sac as a tool for the recognition of bacterial ocular surface inflammation

Abstract

AbstractPurposeOcular surface inflammation (OSI) is one of the most common diseases in ophthalmic practice. Bacteria can be one of many reasons of OSI. Topical antibiotics are prescribed in many cases of OSI. There is an important reason of the increase the antibiotic resistance. An enzyme granulocystic esterase (GE) is a marker of neutral granulocytes activated during bacterial inflammation. The goal of our study was to check the usage of rapid assay of GE in the discharge coming from conjunctival sac in patients with OSI.MethodsDischarge was collected from the conjunctival sac by sterile swab for microbiological cultures and the rapid assay of GE. There is a color reaction of indoxyl with diazonium salt in the assay. The positive result gives the purple color of the test area and its intensity is dependent on the amount of GE.ResultsThe intensity of the of the rapid assay color was the highest in patients with purulent discharge. In most cases, the presence of Staphylococcus aureus and Staphylococcus epidermidis was confirmed. Very low GE activity was found in most patients without purulent discharge. There were few patients without purulent discharge but with positive results of rapid assays and microbiological cultures. There was lack of correlation between intensity of subjective and objective symptoms (except purulent discharge) and positive result of rapid assay and microbiological cultures.ConclusionsA rapid assay of GE seems to be easy tool for the recognition of bacterial etiology of ocular surface inflammation. It can help to limit topical antibiotics usage in the treatment of ocular surface inflammations and reduce the antibiotic resistance.