title: Evaluation of conjunctival bacterial flora in patients with Stevens-Johnson Syndrome.
abstract: OBJECTIVE
  To determine the conjunctival bacterial flora present in patients with Stevens-Johnson syndrome.
  
  
  METHODS
  A prospective study of the conjunctival bacterial flora was performed in 41 eyes of 22 patients with Stevens-Johnson syndrome. The information gathered included the patient's sex and age, the duration of disease, the cause of Stevens-Johnson syndrome, and treatments. Scrapings of the inferior conjunctival fornix were performed in both eyes. Fourteen days before scraping, the patients were asked to interrupt all topical medication and start using 0.5% nonpreserved methylcellulose. The microbiological evaluation included microorganism identification and determination of antibiotic sensitivity.
  
  
  RESULTS
  Of 22 patients (41 eyes), 14 (64%) were females, and eight (36%) were males. The mean age was 33.2 years, and the mean duration of disease was 15.6 years. Visual acuity ranged from light perception to 20/25 (1.57 logMar). The treatment received by most patients consisted of tear substitutes, topical antibiotics, and contact lenses. Bacterial identification was positive in 39 eyes (95%) and negative in two eyes (5%). Gram-positive cocci accounted for 55.5% of the microorganisms, whereas gram-positive bacilli and gram-negative bacilli accounted for 19% and 25.5%, respectively. Half of the patients (54%) had multiple bacterial species in their flora, and only one bacterial species was identified in the other half. Resistant bacteria were isolated from four eyes. The antibiotic sensitivity results for the Streptococcus group showed the lowest sensitivity and the highest microbial resistance identified.
  
  
  CONCLUSIONS
  Patients with Stevens-Johnson syndrome have a diverse conjunctival flora that includes many pathogenic species.
authors.affiliation: Federal University of São Paulo, Vision Institute, Ophthalmology Department, São PauloSP, Brazil, Federal University of São Paulo (UNIFESP), Vision Institute, Ophthalmology Department, São Paulo/SP, Brazil.
authors.forename: Luciana
authors.initials: L
authors.lastname: Frizon
authors.affiliation: Federal University of São Paulo, Vision Institute, Ophthalmology Department, São PauloSP, Brazil, Federal University of São Paulo (UNIFESP), Vision Institute, Ophthalmology Department, São Paulo/SP, Brazil.
authors.forename: Marília Cavalcante
authors.initials: MC
authors.lastname: Araújo
authors.affiliation: Federal University of São Paulo, Vision Institute, Ophthalmology Department, São PauloSP, Brazil, Federal University of São Paulo (UNIFESP), Vision Institute, Ophthalmology Department, São Paulo/SP, Brazil.
authors.forename: Larissa
authors.initials: L
authors.lastname: Andrade
authors.affiliation: Federal University of São Paulo, Vision Institute, Ophthalmology Department, São PauloSP, Brazil, Federal University of São Paulo (UNIFESP), Vision Institute, Ophthalmology Department, São Paulo/SP, Brazil.
authors.forename: Maria Cecília Zorat
authors.initials: MC
authors.lastname: Yu
authors.affiliation: Federal University of São Paulo, Vision Institute, Ophthalmology Department, São PauloSP, Brazil, Federal University of São Paulo (UNIFESP), Vision Institute, Ophthalmology Department, São Paulo/SP, Brazil.
authors.forename: Tais Hitomi
authors.initials: TH
authors.lastname: Wakamatsu
authors.affiliation: Federal University of São Paulo, Vision Institute, Ophthalmology Department, São PauloSP, Brazil, Federal University of São Paulo (UNIFESP), Vision Institute, Ophthalmology Department, São Paulo/SP, Brazil.
authors.forename: Ana Luisa
authors.initials: AL
authors.lastname: Höfling-Lima
authors.affiliation: Federal University of São Paulo, Vision Institute, Ophthalmology Department, São PauloSP, Brazil, Federal University of São Paulo (UNIFESP), Vision Institute, Ophthalmology Department, São Paulo/SP, Brazil.
authors.forename: José Álvaro Pereira
authors.initials: JÁ
authors.lastname: Gomes
mesh_terms: D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D058491:Bacterial Load; D002648:Child; D003228:Conjunctiva / Q000382:microbiology*; D024881:Drug Resistance, Bacterial; D015818:Eye Infections, Bacterial / Q000188:drug therapy / Q000382:microbiology; D005260:Female; D006090:Gram-Negative Bacteria / Q000187:drug effects / Q000302:isolation & purification*; D006094:Gram-Positive Bacteria / Q000187:drug effects / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D011446:Prospective Studies; D013262:Stevens-Johnson Syndrome / Q000382:microbiology*; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents