Department of Medical Laboratory Science, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia.
Department of Health Technology and Informatics, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China.
Sci Rep. 2024 Nov 20;14(1):28744. doi: 10.1038/s41598-024-77723-w.
External ocular infections are of serious global concern, which cause significant visual morbidity and even blindness, particularly in low-income and resource-limited countries. Herewith, we are reporting the profile of bacteria and fungi causing external ocular infections and the associated factors in Arba Minch, southern Ethiopia. An institution-based cross-sectional study was conducted among 259 suspected individuals with external ocular infections from 01 January to 10 June 2020 in Arba Minch General Hospital. The demographic data were obtained using a structured questionnaire, while corneal scrapings and conjunctival swabs were collected for culture. Samples were inoculated onto MacConkey, blood, mannitol salt and Sabouraud dextrose agar plates. Bacteria were characterised using conventional microbiological techniques. Fungal isolates were identified by culture and morphology by means of microscopy. Antibiotic susceptibility tests for bacteria were performed via the Kirby-Bauer disk diffusion technique. A logistic regression analysis determined the association between dependent and independent variables; P values ≤ 0.05 were considered statistically significant. The most common clinical manifestations in culture-proven cases were conjunctivitis (38.6%, n = 100) and blepharoconjunctivitis (25.9%, n = 67). The overall prevalence of external ocular bacterial and fungal infections was 73.2 (n = 115) and 26.8% (n = 42), respectively. Isolates of Staphylococcus aureus (24.8%, n = 39) and Pseudomonas aeruginosa (13.4%, n = 21) were the predominant Gram-positive and Gram-negative bacteria, respectively. The prevalence of multidrug-resistant bacteria was 71.3% (n = 82). The World Health Organisation-prioritised bacteria such as methicillin-resistant S. aureus (61.5%, n = 24), extended-spectrum beta-lactamase (22.6%, n = 12), and carbapenemase-producing Enterobacteriaceae (15.1%, n = 8) were also detected. The prominent fungi recovered from patients with keratitis and conjunctivitis were Aspergillus spp. and Candida albicans, respectively (9.5%, n = 15 each). Age (26-49 years) and family income were statistically associated with ocular infections (P ≤ 0.05). The results provide insights into the characteristics of major ocular bacterial and fungal pathogens circulating in the ophthalmic patients of Arba Minch. Conjunctivitis is the main ocular manifestation observed, with a predominance of S. aureus. More than two-thirds of the ocular bacteria were MDR, and the highest prevalence corresponds to S. aureus. The aggravation of multi-drug resistance, including the WHO-prioritised ones, warrants periodic evaluations.
眼部外感染是一个严重的全球性问题，会导致严重的视力损害，甚至失明，特别是在低收入和资源有限的国家。在此，我们报告了在埃塞俄比亚南部阿巴明奇引起眼部外感染的细菌和真菌的特征，以及相关因素。这是一项在 2020 年 1 月 1 日至 6 月 10 日期间，在阿巴明奇综合医院对 259 名疑似眼部外感染患者进行的基于机构的横断面研究。使用结构化问卷获得人口统计学数据，同时采集角膜刮片和结膜拭子进行培养。将标本接种到 MacConkey、血、甘露醇盐和沙氏葡萄糖琼脂平板上。使用传统的微生物学技术对细菌进行鉴定。通过显微镜检查真菌分离物的形态来鉴定真菌。通过 Kirby-Bauer 圆盘扩散技术对细菌进行抗生素敏感性试验。使用逻辑回归分析确定了因变量和自变量之间的关系，P 值≤0.05 被认为具有统计学意义。在培养证实的病例中，最常见的临床表现是结膜炎（38.6%，n=100）和睑结膜炎（25.9%，n=67）。眼部外细菌和真菌感染的总患病率分别为 73.2%（n=115）和 26.8%（n=42）。金黄色葡萄球菌（24.8%，n=39）和铜绿假单胞菌（13.4%，n=21）分别是主要的革兰氏阳性菌和革兰氏阴性菌。耐多药菌的流行率为 71.3%（n=82）。还检测到世界卫生组织优先考虑的细菌，如耐甲氧西林金黄色葡萄球菌（61.5%，n=24）、超广谱β-内酰胺酶（22.6%，n=12）和产碳青霉烯酶肠杆菌科（15.1%，n=8）。从角膜炎和结膜炎患者中分离出的主要真菌分别为曲霉菌属和白色念珠菌（9.5%，n=15）。年龄（26-49 岁）和家庭收入与眼部感染有统计学关联（P≤0.05）。结果提供了关于阿巴明奇眼科患者中循环的主要眼部细菌和真菌病原体特征的见解。结膜炎是观察到的主要眼部表现，以金黄色葡萄球菌为主。超过三分之二的眼部细菌是多药耐药菌，最高的流行率与金黄色葡萄球菌相对应。包括世界卫生组织优先考虑的药物在内的多药耐药性的恶化需要定期评估。
