Acute bacterial conjuctivitis in children

Abstract number: 1134_03_1

Makri A., Agathokleous X., Papavasileiou H., Lykou F., Manios N., Voyatzi A.

Introduction:  

Acute bacterial conjunctivitis (ABC) is one of the most commonly ocular diseases in children examined by pediatricians at the outpatients Department. Since the treatment is usually empirical and prior cultures are not normally taken, the virulent factors involved in the process are often unidentified.

Objectives:  

1. To determine the incidence of the isolated pathogens from conjunctival exudates cultures and

2.To examine the antibiotic susceptibility for the efficacy of the therapy in the management of confirmed ABC in children.

Methods:

Conjunctival swabs were collected from 780 children, aged 1 month to 14 years old, who were attended with the diagnosis of ABC in our Children Hospital, during a 5-years period (2000–2004). All bacteria were identified by classical microbiological methods and the antimicrobial susceptibility was performed according to NCCLS guidelines.

Results:  

453 cultures out of 780 ocular specimens were positive(58%). A total of 501 bacteria were isolated. The most frequent isolated bacteria were: Haemophilus influenzae (37.5%), Streptococcus pneumoniae (20%), Staphylococcus coagulase negative (CNS) (15.2%),and Staphylococcus aureus (14.8%) followed by Streptococcus viridans (4%), various Gram negative bacteria (3%), Moraxella catarrhalis (2.5%) and Haemophilus spp (1.6%).42 patients developed mixed cultures with two or more types of bacteria. Among 99 isolates of S. pneumoniae tested, were resistant for penicillin 14.1% and for gentamicin (Gm) and tobramycin (Tob) 45.4% and 49.5% respectively. Resistance to ampicillin was recovered in 9.5% of H. influenzae, of 66.6% of S. aureus and in 79.5% of CNS strains. Aminoglycosides showed higher resistance (Gm 17.9%, Tob 25.6%) against CNS isolates, in comparison to S. aureus (Gm 12%, Tob 14.6%) and H. influenzae strains (Gm 1.6%,Tob 2.6%) respectively. The most isolates were sensitive to chloramphenicol and ciprofloxacin.

Conclusions:  

1. The main pathogens causing ABC were H. influenzae and S. pneumoniae.

2. Chloramphenicol and ciprofloxacin showed favorable in vitro activity against the majority of pathogens.

3. Resistance rates indicate the need for continuous surveillance and for motoring studies.