Abstract
Objectives: The aim of the current study was to reveal the bacterial profile and pattern of sensitivity to antibiotics for external ocular infections for patients who attended selected ophthalmology clinics in the city of Sana’a.
 Methods: A cross-sectional study design was used from September 2016 to October 2017 where a total of 197 patients with infection of external eye were included in the study which included conjunctivitis, keratitis, blepharitis and Blepharoconjunctivitis. Samples were collected and transferred to the National Center of Public Laboratories (NCPHL), in Sana'a. Possible bacterial pathogens have been isolated and identified using regular laboratory techniques, and microbial sensitivity testing has been carried out using a disc diffusion method.
 Results: A total of 197 ocular samples were obtained for microbiological evaluation, of these 146 (74.1%) have bacterial growth. Bacteria of Gram positive accounted for 52.1% and the prevalent isolation was S. aureus (30.1%). Gram negative bacteria made up 47.9% and the predominant isolation was Pseudomonas aeruginosa (26.7%). The majority of Gram-positive bacteria were sensitive to ciprofloxacin (90% - 100%), vancomycin (86% - 100%) and Gram-negative isolates sensitive for amikacin (100%) and ciprofloxacin (63% - 100%).
 Conclusion: These results revealed that Gram-positive bacteria were the generally common bacteria isolated from infections of external eye and were more susceptible to vancomycin and ciprofloxacin while Gram-negative isolates were more susceptible to ciprofloxacin and amikacin. The high rate of resistance for most antibiotics in Yemen, leaves ophthalmologists with very few options of drugs to treat eye infections. Large-scale ongoing studies in the future should also be conducted in order to monitor the antimicrobial resistance of the external ocular bacterial isolates.
 Peer Review History: 
 Received 20 May 2020; Revised 25 June; Accepted 4 July, Available online 15 July 2020 
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 Received file 
 
 Average Peer review marks at initial stage: 6.0/10
 Average Peer review marks at publication stage: 7.5/10
 Reviewer(s) detail:
 Name: Dr. Jucimary Vieira dos Santos
 Affiliation: Hemonorte Dalton Barbosa Cunha, Brazil
 E-mail: jucimaryvieira@yahoo.com.br
 Name: Dr. Sabah Hussien El-Ghaiesh
 Affiliation: Tanta University, Egypt
 E-mail: s.ghaiesh@gmail.com
 
 Comments of reviewer(s): 
 
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 EPIDEMIOLOGY, BACTERIAL PROFILE, AND ANTIBIOTIC SENSITIVITY OF LOWER RESPIRATORY TRACT INFECTIONS IN SANA’A AND DHAMAR CITY, YEMEN
Highlights
Pathogenic microorganisms cause ocular infections as a result of virulence and low host resistance in some circumstances such as living conditions, personal hygiene, socioeconomic status, low immunity status, and other related factors[1,2]
Because there is a global problem with the appearance of bacterial resistance to topical antimicrobial agents that are effected by pathogen properties and antibiotic prescribing practices including systemic antibiotic use and general health care guidelines[4,5]
Some other studies have reported that S. aureus is the first but has reported E. coli[9,15], S. albus[2], S. pneumoniae[1,8] as the second common bacterial isolation not P. aeruginosa such as the current study
Summary
Pathogenic microorganisms cause ocular infections as a result of virulence and low host resistance in some circumstances such as living conditions, personal hygiene, socioeconomic status, low immunity status, and other related factors[1,2]. An immediate treatment of a serious bacterial eye infection that threatens the cornea is needed[2]. Isolation and identification of bacterial pathogens along with an antibiotic sensitivity spectrum is required[3]. Because there is a global problem with the appearance of bacterial resistance to topical antimicrobial agents that are effected by pathogen properties and antibiotic prescribing practices including systemic antibiotic use and general health care guidelines[4,5]. This growing resistance increases the risk of treatment failure with potentially severe consequences[6,7]. As well as patterns of resistance, may vary according to geographical and regional location[6,7,8]
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