Acute conjunctivitis – antibiotic susceptibility and resistance to different antibiotics in main Eye Hospital, Tripoli, Libya

Abstract

Acute conjunctivitis is characterized by inflammation of the conjunctiva of less than 3 to 4 weeks duration, cellular infiltration, and exudation. It may also result in corneal, lid, or orbital involvement which may lead to various complications. Bacterial conjunctivitis is a self-limiting process, but topical antibiotic treatment is recommended to eradicate the pathogen and reduce symptom duration. A hospital-based prospective study was conducted in the emergency and casualty department in Zawyat Aldahmani Eye Hospital, Tripoli /Libya comprising out-patients (OPD) visiting the department from June to December 2019 (186 cases). The primary objective was to evaluate the bacteriological pattern and the secondary objectives were to evaluate seasonal variation and antibiotic sensitivity pattern of the isolates. Conjunctival swabs included patients from both sexes (males n_106 and females n_80) and different ages; 80.1% of adults of the whole studied cases and the rest were children under 12 years old. Staph. hominis (26.17%) was the predominant organism isolated throughout the study. The commonest single organism isolates were Staph. haemolyticus (11.21%) Staph. aureus (9.35%). All isolates were identified and susceptibility patterns towards about 34 different antibiotics were studied. There were 186 patients enrolled. Of all cultures, 57.5% (107) yielded one of the study pathogens. Gram-positive organisms were isolated from 83 (77.57%) of cultures, gram-negative organisms were isolated from 15 (14.02%), and 9 (8.4%) were fungal growth. From 107 gram-positive isolates, 19 samples (22.9%) gave coagulase-positive results and 64 samples (77.1%) gave negative results. All the major organisms (S. aureus, S. hominis, S. hemolytic, S. epidermidis, E. coli, Mycobacterium, and Moraxilla catarrhalis) susceptible to cephalosporins, macrolides, aminoglycosides and fluoroquinolones (levofloxacin). Tetracycline has the lowest effect on both gram-positive and gram-negative isolates. In conclusion, our findings should alert physicians on the choice of appropriate antibiotic treatment after applying AST to the identified strains and on the potential role of conjunctivitis in the spread of antibiotic-resistant pathogens. In addition, external bacterial infections of the eye were most frequently caused by the common skin bacteria. Staphylococci spp. was by far the most common bacterial pathogen.