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[Persistence and transient conjunctival pathogen colonization before planned intraocular interventions]
V Rummelt1, H J Boltze, A Jünemann
1Augenklinik mit Poliklinik, Universität Erlangen-Nürnberg.
Abstract:
The risk of a postoperative endophthalmitis is influenced by the presence of a significant bacterial colonisation of the conjunctiva before intraocular surgery. Between February and August 1990 we performed conjunctival smears in 481 patients 1) on the eve of the operation and 2) just before planned intraocular surgery, to evaluate a persistent or transient microbial colonisation of the conjunctiva. 352 patients showed insignificant ("negative") and 129 patients a significant ("positive") bacterial growth in the first conjunctival smear. 96% of the patients (n = 336) had a negative result in both smears. 30% of the patients (n = 37) with a positive conjunctival smear showed a persisting bacterial colonisation, whereas 70% of the patients (n = 92) had a transient colonisation of the conjunctiva with a negative second smear. As a persisting microbial colonisation of the conjunctiva may be an important factor for the development of postoperative endophthalmitis, we recommend prophylactic conjunctival smears before surgery to diminish the risk of intraocular infections after surgery.
Insights
Pre-operative conjunctival bacterial colonization increases endophthalmitis risk. Prophylactic screening via conjunctival smears before intraocular surgery can help reduce the risk of post-operative infections.
Area of Science:
- Ophthalmology
- Microbiology
Context:
- Postoperative endophthalmitis is a serious complication following intraocular surgery.
- Bacterial colonization of the conjunctiva is a known risk factor for endophthalmitis.
Purpose:
- To evaluate persistent or transient microbial colonization of the conjunctiva before intraocular surgery.
- To assess the relationship between conjunctival colonization and the risk of endophthalmitis.
Summary:
- Conjunctival smears were performed on 481 patients before intraocular surgery.
- A significant bacterial growth was found in 129 patients (26.8%).
- Of those with positive initial smears, 30% showed persistent colonization, while 70% had transient colonization.
Impact:
- Persistent microbial colonization of the conjunctiva may be a significant factor in developing postoperative endophthalmitis.
- Recommends prophylactic conjunctival smears before surgery to mitigate the risk of intraocular infections.