[Coagulase-negative staphylococci in normal and chronically inflamed conjunctiva].
This study examines the prevalence of coagulase-negative Staphylococcus species in normal and mildly inflamed conjunctiva, their sensitivity to antibiotics, and their relationship to the remaining flora.


METHODS
In 99 patients including 9 HIV-positives in an early stage of the infection, 100 conjunctival swabs were taken and microbiologically investigated for bacteria and fungi. Thirty-four were from healthy eyes. 40 were from patients with chronic (n = 28) and unspecific (n = 12) conjunctivitis, 17 were from patients with a variety of outer inflammatory ocular conditions, and 9 were from the HIV group from uninfected (n = 6) and infected (n = 3) conjunctivae. Samples from each patient were collected with three moistened cotton swabs and directly inoculated onto five different agars, followed by immersion into three specific culture broths. Staphylococci were identified species-wise, the other microorganisms genus-wise. Sensitivity to a broad spectrum of antibiotics was determined by agar diffusion tests.


RESULTS
Staphylococci were found in 89%, which was the highest prevalence genus-wise. Of those, coagulase-negative species accounted for 86%, while coagulase-positive Staphylococcus aureus was isolated in 12% of all swabs. In the 86 smears positive for coagulase-negative staphylococci, 151 different strains were isolated. In these strains, resistance to the 13 tested antibiotics varied from 0% for vancomycin to 66% for penicillin. Strains which were isolated from patients with chronic conjunctivitis showed a greater range of resistance than those from normal flora, with significant levels for ciprofloxacin, gentamycin and kanamycin (Mann-Whitney) U-test: P < 0.05). All except six strains of staphylococci were identified strains represented ten species, of which Staphylococcus epidermidis was most prevalent (74%), but only made up 70% of all isolated strains of the coagulase-negative staphylococci. Staphylococcus aureus and gram-negative bacteria were found significantly more commonly in patients which chronic conjunctivitis than in healthy eyes, while coagulase-negative species of the Micrococcaceae family were significantly more prevalent in the healthy than in the chronically inflamed conjunctiva (chi-square: P < 0.05).


CONCLUSIONS
The conjunctiva can simultaneously host several stems of coagulase-negative staphylococci, which differ in regard to species and resistance to antibiotics. This variety might indicate a microbiological balance of the conjunctiva and be reduced in chronic inflammatory conditions. In patients with chronic conjunctivitis the risk for multiresistant coagulase-negative staphylococci is increased.
Grasbon
T
T
Augenklinik, Universität M nchen.
Miño de Kaspar
H
H
Klauss
V
V
D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis / Q000382:microbiology; D001762:Blepharitis / Q000175:diagnosis / Q000382:microbiology; D002908:Chronic Disease; D003228:Conjunctiva / Q000382:microbiology*; D003234:Conjunctivitis, Bacterial / Q000382:microbiology*; D003470:Culture Media; D018432:Drug Resistance, Multiple; D005260:Female; D006801:Humans; D007637:Keratoconjunctivitis / Q000175:diagnosis / Q000382:microbiology; D008297:Male; D008826:Microbial Sensitivity Tests; D011446:Prospective Studies; D012016:Reference Values; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000382:microbiology*; D013210:Staphylococcus / Q000145:classification / Q000187:drug effects / Q000302:isolation & purification; D013211:Staphylococcus aureus / Q000187:drug effects / Q000302:isolation & purification; D013212:Staphylococcus epidermidis / Q000187:drug effects / Q000302:isolation & purification
D003470:Culture Media
Koagulasenegative Staphylokokken auf der blanden und chronisch entzündeten Bindehaut.