加纳眼科诊所中使用中的局部诊断性眼科药物的微生物安全问题

Microbial safety implications of in-use topical diagnostic ophthalmic medications in eye clinics in Ghana.

作者信息

Kyei Samuel, Appiah Eric, Ayerakwa Eunice Ampadubea, Antwi Clara Bemmah, Asiedu Kofi

机构信息

Department of Optometry and Vision Science, School of Allied Health Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana.

Department of Biomedical Sciences, School of Allied Health Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana.

出版信息

J Optom. 2019 Oct-Dec;12(4):263-271. doi: 10.1016/j.optom.2019.02.002. Epub 2019 Aug 29.

DOI:10.1016/j.optom.2019.02.002

PMID:31473175

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6978605/

Abstract

PURPOSE

To determine the microbial contaminants and its clinical importance in topical diagnostic ophthalmic medications (cycloplegics/mydriatics and miotics) in eye clinics in Ghana.

METHOD

A cross-section of eye clinics was sampled for the diagnostic agents (Atropine, Phenylephrine, Tropicamide and Cyclopentolate, Pilocarpine). Standard laboratory procedures and protocols were observed in culturing the samples on different Agars. Microscopy and various biochemical tests were performed to identify microbial species. Antimicrobial susceptibility testing was also performed to ascertain the clinical importance of the isolated microbes.

RESULTS

A total of 113 samples were obtained, from which 334 bacteria were isolated which included Bacilli spp. 91(27.25%), Coagulase Negative Staphylococci spp. 59(17.66%), Moraxella spp. 47(14.07%), Staphylococcus aureus 41(12.27%), Streptococcus spp. 21(6.29%), Klebsiella spp. 20(5.99%), Pseudomonas spp. 13(3.89%), Proteus spp. 12(3.59%), Escherichia coli. 12 (3.59%), Serratia spp. 10(2.99%), Shigella spp. 7(2.09%), Salmonella spp. 1(0.3%). There were 96 isolated fungal contaminants mainly Penicillium spp. 41(42.71%), Cephalosporium spp. 19(19.79%), Cladosporium spp. 15(15.63%), Aspergillus spp. 13(13.54%), Cercospora spp. 8(8.33%). The diagnostic agent with the most bacteria contamination was Phenylephrine 90 (26.95%) and the least being Pilocarpine 49 (14.67%). Also, the diagnostic agent with the most fungal contamination was Cyclopentolate 29 (30.2%) and the least was Tropicamide and Pilocarpine with 15 (15.63%) each. Gentamicin and Ciprofloxacin were the only antibiotics that showed 100% activity against all the bacterial isolates. Fungal contaminants were more susceptible to Ketoconazole as compared to Fluconazole.

CONCLUSION

Topical diagnostic ophthalmic preparations used in clinical settings in Ghana are contaminated with clinically important bacteria and fungi.

摘要

目的

确定加纳眼科诊所局部诊断用眼科药物（睫状肌麻痹剂/散瞳剂和缩瞳剂）中的微生物污染物及其临床重要性。

方法

选取部分眼科诊所的诊断药物（阿托品、去氧肾上腺素、托吡卡胺、环喷托酯、毛果芸香碱）进行采样。在不同琼脂培养基上培养样本时遵循标准实验室程序和方案。进行显微镜检查和各种生化试验以鉴定微生物种类。还进行了抗菌药敏试验以确定分离出的微生物的临床重要性。

结果

共获得113个样本，从中分离出334株细菌，包括芽孢杆菌属91株（27.25%）、凝固酶阴性葡萄球菌属59株（17.66%）、莫拉菌属47株（14.07%）、金黄色葡萄球菌41株（12.27%）、链球菌属21株（6.29%）、克雷伯菌属20株（5.99%）、假单胞菌属13株（3.89%）、变形杆菌属12株（3.59%）、大肠杆菌12株（3.59%）、沙雷菌属10株（2.99%）、志贺菌属7株（2.09%）、沙门菌属1株（0.3%）。有96株分离出的真菌污染物，主要是青霉属41株（42.71%）、头孢霉属19株（19.79%）、枝孢菌属15株（15.63%）、曲霉属13株（13.54%）、尾孢菌属8株（8.33%）。细菌污染最多的诊断药物是去氧肾上腺素90株（26.95%），最少的是毛果芸香碱49株（14.67%）。此外，真菌污染最多的诊断药物是环喷托酯29株（30.2%），最少的是托吡卡胺和毛果芸香碱，各有15株（15.63%）。庆大霉素和环丙沙星是仅有的对所有分离出的细菌均显示100%活性的抗生素。与氟康唑相比，真菌污染物对酮康唑更敏感。