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  • Risk Factors for Bacterial Conjunctival Flora in Preoperative Cataract Patients

    By Marianne Doran and edited by Deepak P. Edward, MD
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    Journal Highlights

    Eye
    Published online July 15, 2016

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    Hoshi et al.     investigated the types of aerobic bacterial conjunctival flora present in preoperative cataract pa­tients and the impact of these patho­gens on endophthalmitis. They found that bacterial colonization varied by pa­tient demographic and medical factors.

    This study, conducted in Japan, included 990 cataract surgery patients. Data on factors including age, sex, diabetes, hypertension, and use of oral steroids or glaucoma eye drops were obtained from medical records. Lacrimal drainage was assessed via irrigation. Conjunctival specimens were obtained by swabbing and were cultured, and risk factors for 7 typical bacteria were analyzed by univariate and multivariate analyses.

    The investigators found that the detection rate of alpha-hemolytic Streptococci and Enterococcus faecalis increased with age. They also noted that the detection rate of gram-nega­tive bacilli was higher among patients who had used oral steroids (odds ratio [OR], 3.29) or who had experienced lacrimal duct obstruction (OR, 4.75). Corynebacterium species were detected more frequently among older patients and men, and less frequently among patients who used glaucoma eye drops.

    Among other findings, the detec­tion rate of methicillin-susceptible coagulase-negative Staphylocococci was higher among men and lower among patients with a history of surgery in other hospital departments; while the rate of methicillin-resistant coagu­lase-negative Staphylococci (MR-CNS) was higher among patients with oral steroid use (OR, 3.65), a history of vis­its to ophthalmic facilities (OR, 1.65), or a surgical history in other depart­ments (OR, 2.80).

    The researchers concluded that risk factors for each type of conjunctival bacteria and for endophthalmitis var­ied according to patient characteristics. Elderly patients, men, people with lacrimal duct obstruction, or immuno­suppressed individuals were more likely to be colonized by pathogens that cause postoperative endophthalmitis. In particular, the presence of MR-CNS in the conjunctival flora was linked with health care–associated infection. To prevent the spread of MR-CNS in ophthalmology departments, strict observance of standard precautions is critically important.

    The original article can be found here.