Microbial flora and resistance in ophthalmology: a review

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Abstract

Antibiotic resistance in systemic infection is well-researched and well-publicized. Much less information is available on the resistance of normal ocular microbiome and that of ophthalmic infections. An understanding of the distribution of ocular microorganisms may help us in tailoring our empiric treatment, as well as in choosing effective pre-, peri- and postoperative management, to achieve the best results for patients. This study aims to summarize and review the available literature on the subject of normal ocular flora and its resistance, as well as the broader topic of antibiotic resistance in ophthalmology.

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Most cited references 53

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Health-care workers: source, vector, or victim of MRSA?

Werner Albrich, Stephan Harbarth (2008)

There is ongoing controversy about the role of health-care workers in transmission of meticillin-resistant Staphylococcus aureus (MRSA). We did a search of the literature from January, 1980, to March, 2006, to determine the likelihood of MRSA colonisation and infection in health-care workers and to assess their role in MRSA transmission. In 127 investigations, the average MRSA carriage rate among 33 318 screened health-care workers was 4.6%; 5.1% had clinical infections. Risk factors included chronic skin diseases, poor hygiene practices, and having worked in countries with endemic MRSA. Both transiently and persistently colonised health-care workers were responsible for several MRSA clusters. Transmission from personnel to patients was likely in 63 (93%) of 68 studies that undertook genotyping. MRSA eradication was achieved in 449 (88%) of 510 health-care workers. Subclinical infections and colonisation of extranasal sites were associated with persistent carriage. We discuss advantages and disadvantages of screening and eradication policies for MRSA control and give recommendations for the management of colonised health-care workers in different settings.

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Core elements of hospital antibiotic stewardship programs from the Centers for Disease Control and Prevention.

Loria Pollack, Arjun Srinivasan (2014)

The proven benefits of antibiotic stewardship programs (ASPs) for optimizing antibiotic use and minimizing adverse events, such as Clostridium difficile and antibiotic resistance, have prompted the Centers for Disease Control and Prevention (CDC) to recommend that all hospitals have an ASP. This article summarizes Core Elements of Hospital Antibiotic Stewardship Programs, a recently released CDC document focused on defining the infrastructure and practices of coordinated multidisciplinary programs to improve antibiotic use and patient care in US hospitals.

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Ocular pathogen or commensal: a PCR-based study of surface bacterial flora in normal and dry eyes.

James S G Dooley, C. S. Downes, Sophie E. Moore … (2007)

To compare the bacterial population of the ocular surface of normal and dry eye subjects using conventional culture and 16S rDNA PCR. Ninety-one subjects were classified as normal (n = 57) or dry eye (n = 34) by using tear break-up time, McMonnies survey, goblet cell density, and meibomian gland assessment. Conventional bacterial culture and broad-range 16S rDNA PCR, cloning, and DNA sequencing were used for bacterial identification. Repeated sampling was performed in a subset of subjects over a 3-month period. The association between goblet cell loss and bacterial counts in a subgroup of subjects was assessed. Most of the bacteria identified by culture were coagulase negative staphylococci, whereas molecular methods demonstrated a considerable number of additional bacteria. Atypical ocular surface bacteria including Rhodococcus erythropolis, Klebsiella oxytoca, and Erwinia sp., were identified in cases of overt inflammation and, surprisingly, on the normal ocular surface. The same bacteria remained on the ocular surface after repeated sampling. Increased bacterial flora was associated with reduced goblet cell density. Molecular analysis revealed a diverse ocular surface bacterial population. In addition to the normal flora, various potentially pathogenic bacteria were identified. The detection of known pathogens in both normal and dry eyes, with minimal signs of infection, presents a diagnostic dilemma. It remains unknown whether their presence is associated with inflammation and reduced goblet cell density or whether they adversely affect the ocular surface predisposing it to abnormal microbial colonization. In the absence of overt clinical infection, it is unknown whether such results should prompt intervention with therapy.

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Author and article information

Contributors

Andrzej Grzybowski: ae.grzybowski@gmail.com

Journal

Journal ID (nlm-ta): Graefes Arch Clin Exp Ophthalmol

Journal ID (iso-abbrev): Graefes Arch. Clin. Exp. Ophthalmol

Title: Graefe's Archive for Clinical and Experimental Ophthalmology

Publisher: Springer Berlin Heidelberg (Berlin/Heidelberg )

ISSN (Print): 0721-832X

ISSN (Electronic): 1435-702X

Publication date (Electronic): 22 February 2017

Publication date PMC-release: 22 February 2017

Publication date (Print): 2017

Volume: 255

Issue: 5

Pages: 851-862

Affiliations

[1 ]Department of Ophthalmology, Poznan City Hospital, Ul. Szwajcarska 3, 60-285 Poznan, Poland

[2 ]ISNI 0000 0001 2149 6795, GRID grid.412607.6, Department of Ophthalmology, , University of Warmia and Mazury, ; Olsztyn, Poland

[3 ]ISNI 0000 0001 2264 7217, GRID grid.152326.1, Department of Ophthalmology, , Vanderbilt University, ; Nashville, TN USA

Article

Publisher ID: 3608

DOI: 10.1007/s00417-017-3608-y

PMC ID: 5394129

PubMed ID: 28229218

SO-VID: 20f1569c-7cad-4ac1-a17f-8b33b5fd9abb

License:

Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

History

Date received : 5 September 2016

Date revision received : 11 January 2017

Date accepted : 6 February 2017

Funding

Funded by: Foundation for Ophthalmology Development, “Ophthalmology 21”, Poznan, Poland

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ScienceOpen disciplines: Ophthalmology & Optometry

Keywords: antibiotic resistance in ophthalmology,ocular microbiome,ocular microbial flora,ocular flora,trust,armor

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ScienceOpen disciplines: Ophthalmology & Optometry

Keywords: antibiotic resistance in ophthalmology, ocular microbiome, ocular microbial flora, ocular flora, trust, armor

Microbial flora and resistance in ophthalmology: a review

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Abstract

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Karger: Ophthalmology

Most cited references 53

Health-care workers: source, vector, or victim of MRSA?

Core elements of hospital antibiotic stewardship programs from the Centers for Disease Control and Prevention.

Ocular pathogen or commensal: a PCR-based study of surface bacterial flora in normal and dry eyes.

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