Conjunctival flora in patients with human immunodeficiency virus infection.
OBJECTIVE
To compare the conjunctival flora of human immunodeficiency virus (HIV)-positive and HIV-negative patients. Also, to assess the prophylactic effect of oral clarithromycin against Mycobacterium avium complex on the conjunctival flora of HIV-positive patients.


METHODS
Ninety-four eyes of 47 HIV-positive patients and 122 eyes of 61 control patients were examined. All participants had a detailed anterior segment examination, including conjunctival cultures and laboratory blood tests. Culture results for different organisms were evaluated by chi-square analysis between the groups. The effect of systemic antibiotic treatment on the conjunctival flora of patients with HIV infection was evaluated by chi-square analysis.


RESULTS
Bacterial organisms in the conjunctival sac were detected in four out of 28 (14.3%) eyes of HIV-positive patients treated with systemic clarithromycin and in 32 out of 66 (48.5%) eyes of HIV-positive patients without systemic clarithromycin treatment (p < 0.01). The CD4-positive T-cell counts in these groups were 158/microl and 416/microl, respectively (p < 0.01). Bacterial organisms were also detected in 46 of 122 (37.7%) control eyes. No difference was observed in the types and proportions of organisms isolated from the conjunctiva between HIV-positive patients without systemic clarithromycin treatment and controls.


CONCLUSIONS
There was no difference between the conjunctival flora of HIV-negative and HIV-positive patients. Systemic clarithromycin treatment decreased the conjunctival flora of HIV patients, including those who had a CD4 count that was less than 50/microl.
Yamauchi
Yasuyuki
Y
Department of Ophthalmology, Tokyo Medical University Hospital, Shinjuku, Tokyo, Japan. fwkb0154@nifty.com
Minoda
Hiroshi
H
Yokoi
Katsutoshi
K
Maruyama
Katsuhiko
K
Kumakura
Shigeto
S
Usui
Masahiko
M
Cruz
Jose M C
JM
Fukutake
Katsuyuki
K
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D019072:Antibiotic Prophylaxis; D001431:Bacteriological Techniques; D018791:CD4 Lymphocyte Count; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology; D017291:Clarithromycin / Q000627:therapeutic use; D015169:Colony Count, Microbial; D003228:Conjunctiva / Q000187:drug effects / Q000382:microbiology*; D004338:Drug Combinations; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000276:immunology / Q000382:microbiology*; D006801:Humans; D008297:Male; D013420:Sulfamethoxazole / Q000031:analogs & derivatives / Q000627:therapeutic use; D014295:Trimethoprim / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D004338:Drug Combinations; C072764:potrox; D014295:Trimethoprim; D017291:Clarithromycin; D013420:Sulfamethoxazole