Characterization of Conjunctival Microflora and Antibiotic Sensitivity Patterns in Patients Undergoing Cataract Surgery

This study aims to characterize the conjunctival flora of patients scheduled for cataract surgery and determine the susceptibility profile of isolated bacteria to several commonly used topical antibiotics. Conjunctival swabs were taken from 44 consecutive patients (25 males, 19 females; mean age of...

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Main Authors: Aldo Vagge, Filippo Lixi, Diego Ponzin, Chiara Del Noce, Davide Camposampiero, Marcello Santocono, Carlo Enrico Traverso, Vincenzo Scorcia, Giuseppe Giannaccare
Format: Article
Language:English
Published: MDPI AG 2025-01-01
Series:Microorganisms
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Online Access:https://www.mdpi.com/2076-2607/13/2/227
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author Aldo Vagge
Filippo Lixi
Diego Ponzin
Chiara Del Noce
Davide Camposampiero
Marcello Santocono
Carlo Enrico Traverso
Vincenzo Scorcia
Giuseppe Giannaccare
author_facet Aldo Vagge
Filippo Lixi
Diego Ponzin
Chiara Del Noce
Davide Camposampiero
Marcello Santocono
Carlo Enrico Traverso
Vincenzo Scorcia
Giuseppe Giannaccare
author_sort Aldo Vagge
collection DOAJ
description This study aims to characterize the conjunctival flora of patients scheduled for cataract surgery and determine the susceptibility profile of isolated bacteria to several commonly used topical antibiotics. Conjunctival swabs were taken from 44 consecutive patients (25 males, 19 females; mean age of 75.0 ± 12.6 years) who were scheduled for senile cataract surgery at two Italian centers before starting any prophylactic preoperative treatment. Swabs were processed for the detection of the microbial growth and for species identification. Selective culture media were used, and bacteria were identified using the MicroScan Specialty ID Panels (Beckman Coulter<sup>®</sup>, Brea, CA, USA). Antimicrobial susceptibility for the following antibiotics (netilmicin, tobramycin, ofloxacin, oxacillin, levofloxacin, moxifloxacin, chloramphenicol, cefuroxime, and azithromycin) were assessed using the Kirby–Bauer disk diffusion method. Susceptibility for oxacillin was useful to identify methicillin-resistant <i>Staphylococcus aureus</i> (MRSA) and methicillin-resistant <i>Staphylococcus epidermidis</i> (MRSE). Among the swabs analyzed, 61.4% showed only saprophytic flora, 30.7% showed only potential pathogenic flora, and 8.0% showed mixed flora. <i>S. epidermidis</i> (20.5%), <i>S. intermedius</i> (18.2%), and <i>S. aureus</i> (14.8%) were the most frequent isolates; MRSA and MRSE accounted for 8.0% and 6.8% of isolates. Less frequently (9%), Gram-negative bacteria such as <i>Pseudomonas fluorescent</i>, <i>Serratia marcescens</i>, <i>Moraxella lacunata</i>, <i>Morganella morgani</i>, and <i>Stenotrophomonas maltophila</i> were detected. All isolated organisms showed an excellent sensitivity to moxifloxacin and chloramphenicol (range 83–100%, range 67–100%, Gram-positive sensitivity for moxifloxacin and chloramphenicol, respectively; 100% Gram-negative sensitivity for both). A significant percentage of the eyes of candidates for surgery presented potential pathogenic flora alone or in association with saprophytic organisms. Staphylococci were the most frequently isolated bacteria. Tobramycin and Ofloxacin, widely used in the ophthalmic field, are confirmed to have a reduced sensitivity in vitro.
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spelling doaj-art-e09473abe21e4165a12e7be7d26b45872025-08-20T02:44:56ZengMDPI AGMicroorganisms2076-26072025-01-0113222710.3390/microorganisms13020227Characterization of Conjunctival Microflora and Antibiotic Sensitivity Patterns in Patients Undergoing Cataract SurgeryAldo Vagge0Filippo Lixi1Diego Ponzin2Chiara Del Noce3Davide Camposampiero4Marcello Santocono5Carlo Enrico Traverso6Vincenzo Scorcia7Giuseppe Giannaccare8Eye Clinic of Genoa, Policlinico San Martino, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, 16132 Genoa, ItalyEye Clinic, Department of Surgical Sciences, University of Cagliari, 09123 Cagliari, ItalyInternational Center for Ocular Physiopathology, Veneto Eye Bank Foundation, 30174 Venice, ItalyEye Clinic of Genoa, Policlinico San Martino, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, 16132 Genoa, ItalyInternational Center for Ocular Physiopathology, Veneto Eye Bank Foundation, 30174 Venice, ItalyOphthalmology Unit (Santocono), Hospital Di Stefano, 95128 Catania, ItalyEye Clinic of Genoa, Policlinico San Martino, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, 16132 Genoa, ItalyOphthalmology Unit, Renato Dulbecco Hospital, University Magna Graecia of Catanzaro, 88100 Catanzaro, ItalyEye Clinic, Department of Surgical Sciences, University of Cagliari, 09123 Cagliari, ItalyThis study aims to characterize the conjunctival flora of patients scheduled for cataract surgery and determine the susceptibility profile of isolated bacteria to several commonly used topical antibiotics. Conjunctival swabs were taken from 44 consecutive patients (25 males, 19 females; mean age of 75.0 ± 12.6 years) who were scheduled for senile cataract surgery at two Italian centers before starting any prophylactic preoperative treatment. Swabs were processed for the detection of the microbial growth and for species identification. Selective culture media were used, and bacteria were identified using the MicroScan Specialty ID Panels (Beckman Coulter<sup>®</sup>, Brea, CA, USA). Antimicrobial susceptibility for the following antibiotics (netilmicin, tobramycin, ofloxacin, oxacillin, levofloxacin, moxifloxacin, chloramphenicol, cefuroxime, and azithromycin) were assessed using the Kirby–Bauer disk diffusion method. Susceptibility for oxacillin was useful to identify methicillin-resistant <i>Staphylococcus aureus</i> (MRSA) and methicillin-resistant <i>Staphylococcus epidermidis</i> (MRSE). Among the swabs analyzed, 61.4% showed only saprophytic flora, 30.7% showed only potential pathogenic flora, and 8.0% showed mixed flora. <i>S. epidermidis</i> (20.5%), <i>S. intermedius</i> (18.2%), and <i>S. aureus</i> (14.8%) were the most frequent isolates; MRSA and MRSE accounted for 8.0% and 6.8% of isolates. Less frequently (9%), Gram-negative bacteria such as <i>Pseudomonas fluorescent</i>, <i>Serratia marcescens</i>, <i>Moraxella lacunata</i>, <i>Morganella morgani</i>, and <i>Stenotrophomonas maltophila</i> were detected. All isolated organisms showed an excellent sensitivity to moxifloxacin and chloramphenicol (range 83–100%, range 67–100%, Gram-positive sensitivity for moxifloxacin and chloramphenicol, respectively; 100% Gram-negative sensitivity for both). A significant percentage of the eyes of candidates for surgery presented potential pathogenic flora alone or in association with saprophytic organisms. Staphylococci were the most frequently isolated bacteria. Tobramycin and Ofloxacin, widely used in the ophthalmic field, are confirmed to have a reduced sensitivity in vitro.https://www.mdpi.com/2076-2607/13/2/227ocular microfloracataract surgeryantibioticsantimicrobial resistance
spellingShingle Aldo Vagge
Filippo Lixi
Diego Ponzin
Chiara Del Noce
Davide Camposampiero
Marcello Santocono
Carlo Enrico Traverso
Vincenzo Scorcia
Giuseppe Giannaccare
Characterization of Conjunctival Microflora and Antibiotic Sensitivity Patterns in Patients Undergoing Cataract Surgery
Microorganisms
ocular microflora
cataract surgery
antibiotics
antimicrobial resistance
title Characterization of Conjunctival Microflora and Antibiotic Sensitivity Patterns in Patients Undergoing Cataract Surgery
title_full Characterization of Conjunctival Microflora and Antibiotic Sensitivity Patterns in Patients Undergoing Cataract Surgery
title_fullStr Characterization of Conjunctival Microflora and Antibiotic Sensitivity Patterns in Patients Undergoing Cataract Surgery
title_full_unstemmed Characterization of Conjunctival Microflora and Antibiotic Sensitivity Patterns in Patients Undergoing Cataract Surgery
title_short Characterization of Conjunctival Microflora and Antibiotic Sensitivity Patterns in Patients Undergoing Cataract Surgery
title_sort characterization of conjunctival microflora and antibiotic sensitivity patterns in patients undergoing cataract surgery
topic ocular microflora
cataract surgery
antibiotics
antimicrobial resistance
url https://www.mdpi.com/2076-2607/13/2/227
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