Bacterial conjunctival flora and antimicrobial susceptibility profile in patients undergoing cataract surgery: A hospital-based cross-sectional study

• Author Details:   
• Shambhu Suman
• Prakash Kumar
• Archana Archana
• Prem Shankar Patel
• Mukesh Kumar ^*

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Background: Post-surgical endophthalmitis after cataract surgery is a devastating complication, owing to loss or worsening of vision. Gram-positive bacteria are the most common culprits. The present study aims to determine conjunctival flora in patients undergoing cataract surgery along with their antimicrobial susceptibility profile.

Methods: This study was conducted on 100 patients undergoing cataract surgery, between March 2021 to November 2022. Conjunctival swabs were sent for aerobic culture and sensitivity.

Collected data was entered in MS Excel sheet, and analysed for a Simple percentage method using SPSS version 22.0.

Result: Only 34/100 (34%) swabs yielded bacterial growth whereas 66(66%) were negative. 24/34 (70.6%) were gram positive and 10(29.4%) gram negative. Staphylococcus aureus 12/24(50.0%), was most common isolate and 4(16.7%) were Methicillin-resistant. CoNS 10(41.7%) was second most common followed by Streptococcus spp. 2(8.3%).

Gram positives showed 100% susceptibility to gentamicin and vancomycin. 20% of CoNS, were resistant to chloramphenicol, ciprofloxacin, and moxifloxacin whereas 40% were resistant to Ofloxacin. For Staphylococcus aureus 50% were resistant to chloramphenicol and ciprofloxacin and none susceptible to ofloxacin. Streptococcus spp. showed 100% in vitro susceptibility to tested antibiotics.

Gram negatives showed 100% susceptibility to gentamicin, ciprofloxacin, polymyxin B, tobramycin, and moxifloxacin. Of 4 (40.0%) isolates of each Klebsiella pneumoniae and Moraxella catarhhalis, 50% were resistant to ceftazidime. All 2 (100%) isolates of Escherichia coli were resistant to ceftazidime.

Conclusion: Lack of antibiotic policy and indiscriminate use may have led to the emergence of resistant strains. Surveillance is essential for monitoring resistance. Antibiotic policy should be introduced to preserve the effectiveness of antibiotics.

Keywords: Endophthalmitis, Cataract, Bacterial flora.