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Pneumococci in ocular disease of children and their treatment
V M Mahajan1, U Bareja, K Prakash
1Department of Ocular Microbiology, Dr Rajendra Prasad Centre for Opthalmic Sciences, All India Institute of Medical Sciences, New Delhi.
Insights
Streptococcus pneumoniae is a common cause of pediatric eye infections, particularly dacryocystitis. Chloramphenicol and cloxacillin show effectiveness against these ocular pneumococcal strains in India.
Area of Science:
- Ophthalmology
- Microbiology
- Infectious Diseases
Background:
- Pediatric ocular infections pose significant health challenges.
- Streptococcus pneumoniae is a leading bacterial cause of these infections.
- Understanding antibiotic resistance patterns is crucial for effective treatment.
Purpose of the Study:
- To identify and serotype ocular isolates of Streptococcus pneumoniae from children in India.
- To determine the antibiotic susceptibility patterns of these isolates.
- To evaluate the efficacy of chloramphenicol and cloxacillin for pneumococcal ocular infections.
Main Methods:
- Collected 171 Streptococcus pneumoniae isolates from pediatric ocular infections.
- Performed serotyping on 19 of the isolates.
- Assessed antibiotic resistance to erythromycin and chloramphenicol.
Main Results:
- Dacryocystitis was the most common source of isolates (74.4%).
- Lowest resistance observed for erythromycin (17.6%) and chloramphenicol (31.0%).
- Identified common serotypes including 3, 46, 8, 28, 29, 45, 21, and 18.
Conclusions:
- Streptococcus pneumoniae is prevalent in pediatric ocular infections in India.
- Chloramphenicol and cloxacillin are effective treatments for pneumococcal ocular infections.
- This study provides valuable data on ocular pneumococcal serotypes from a developing country.
Abstract:
A total of 171 isolates of Streptococcus pneumoniae were obtained from eyes of children who had congenital dacryocystitis, congenital cataract and glaucoma, acute bacterial conjunctivitis, corneal ulceration, nasolacrimal duct block, or discharging socket, or who had developed ectropion, endophthalmitis and orbital cellulitis. The highest number of strains was obtained from cases of dacryocystitis (74.4%), followed by conjunctivitis (8.2%) and those having developed nasolacrimal duct block (7.6%). The least overall resistance was to erythromycin (17.6%) and chloramphenicol (31.0%). Erythromycin being unavailable for ocular use in India, chloramphenicol was reported to be one of the best drugs against pneumococcal ocular infections in children, the other being cloxacillin, a 2.5% solution of which is made from injectable cloxacillin and used as an ophthalmic preparation. Their use on patients has met with considerable success. Nineteen out of 20 isolates were typeable--the types being 3, 46, 8, 28, 29, 45, 21 and 18. To the best of our knowledge, this is the first report from a developing country of serotyping ocular strains of pneumococci.