Pasteurella canis and Granulicatella adiacens conjunctivitis outbreak resistant to empirical treatment in a child welfare agency.
OBJECTIVE
To investigate pathogens associated with bacterial conjunctivitis resistant to the empirical treatment and their antibiotic resistance in a child welfare agency.


METHODS
Twenty-eight eyes in 14 children with a median age of 3 months with conjunctivitis resistant to the empirical treatment were included in this study. Samples were taken three times from the inferior fornix in both eyes using cotton swabs, cultured onto chocolate and blood agar, and prepared for Gram staining. Antibiograms were evaluated according to the Clinical and Laboratory Standards Institute criteria by disc diffusion method.


RESULTS
The conjunctival culture positivity rate was 35.7% in eyes with conjunctivitis resistant to the empirical treatment. The most common isolated bacteria were Pasteurella canis (25%), penicillin-nonsusceptible Streptococcus pneumoniae (7.1%), and Granulicatella adiacens (3.6%). According to culture results, ophthalmic solutions of vancomycin (50 mg/mL) or gentamicin (30 mg/mL) were applied in eyes with positive conjunctival culture. Previously applied multiple treatments were stopped in eyes with negative conjunctival culture. All eyes improved clinically during follow-up.


CONCLUSIONS
Because unusual pathogens may cause a conjunctivitis outbreak, physicians should not insist on empirical treatment. Taking conjunctival culture and antibiotic switching according to antibiogram may be helpful.
Departments of Ophthalmology, Bagcilar Education and Research Hospital, Istanbul, Turkey. drmelkebalkoglu@yahoo.com
Melike
M
Balikoglu-Yilmaz
Tolga
T
Yilmaz
Ayse Banu
AB
Esen
Kaya N
KN
Engin
Muhittin
M
Taskapili
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D056568:Carnobacteriaceae / Q000302:isolation & purification*; D002669:Child Welfare / Q000706:statistics & numerical data; D002675:Child, Preschool; D003234:Conjunctivitis, Bacterial / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D004196:Disease Outbreaks; D024881:Drug Resistance, Bacterial; D005260:Female; D005839:Gentamicins / Q000627:therapeutic use; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D006801:Humans; D007223:Infant; D008297:Male; D008826:Microbial Sensitivity Tests; D009883:Ophthalmic Solutions; D010325:Pasteurella / Q000302:isolation & purification*; D010326:Pasteurella Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D014421:Turkey / Q000453:epidemiology; D014640:Vancomycin / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D005839:Gentamicins; D009883:Ophthalmic Solutions; D014640:Vancomycin