Evaluation of patients with dry eye disease for conjunctivalChlamydia trachomatisandUreaplasma urealyticum.
OBJECTIVE
To determine the possibility of the development of dry eye disease (DED) as a result of persistent infection withChlamydia trachomatisandUreaplasma urealyticumin the conjunctiva of patients.


METHODS
This study was conducted on 58 patients of age range 20-50y, diagnosed with DED confirmed by Schirmer I test and tear breakup time. The non-dry eye control group included 27 subjects of the same age. Ocular specimens were collected as conjunctival scrapings and swabs divided into three groups: the first used for bacterial culture, the second and third taken to detectChlamydia trachomatisandUreaplasma urealyticumby direct fluorescent antibody (DFA) assay and polymerase chain reaction (PCR) method.


RESULTS
Chlamydia trachomatiswas detected in 65.5% and 76% of DED patients by DFA and PCR methods respectively.Ureaplasma urealyticumwas found in 44.8% of DED infected patients using the PCR method. Both organisms were identified in only 37.9% of DED patients found to be infected. Control subjects had a 22% detection rate ofChlamydia trachomatisby DFA assay versus a 7% detection rate by PCR; whileUreaplasma urealyticumwas detected in 3.7% of the controls by PCR method. The conjunctival culture revealed that gram positive microorganisms represented 75% of isolates with coagulase negative Staphylococci the most common (50%) followed byStaphylococcus aureus(20%), whereas gram negative microorganisms occurred in 25% of cases, isolatingMoraxellaspp. as the most frequent organism.


CONCLUSIONS
Our results tend to point out thatChlamydia trachomatisandUreaplasma urealyticumwere detected in a moderate percentage of patients with DED, and could be a fair possibility for its development. PCR is more reliable in detectingChlamydia trachomatisthan DFA technique. The presence of isolated conjunctival bacterial microflora can be of some potential value.
Microbiology and Immunology Department, Research Institute of Ophthalmology, Giza12556, Egypt.
Maha Mohssen
MM
Abdelfattah
Microbiology and Immunology Department, Faculty of Pharmacy, Cairo University, Kasr Al-Aini 11562, Cairo, Egypt.
Rania Abdelmonem
RA
Khattab
Microbiology and Immunology Department, Research Institute of Ophthalmology, Giza12556, Egypt.
Magda H
MH
Mahran
Ophthalmology Department, Research Institute of Ophthalmology, Giza 12556, Egypt.
Ebrahim S
ES
Elborgy
Chlamydia trachomatis; Ureaplasma urealyticum; conjunctiva; direct fluorescent antibody; dry eye disease; polymerase chain reaction