Pattern of Susceptibility Antibiotics against Clinical Isolates of Conjunctivitis from Sudanese Patients in Khartoum State
Abstract
Resistant Antibiotics of bacterial conjunctivitis is a major challenge globally. The study aimed to determine the most common bacterial agents and risk factors, associated with Conjunctivitis among Sudanese patients and the sensitivity of the antibiotics used against isolates bacteria. The study was cross-sectional and carried out in MAKKA and Allwaledin Eye Hospital over three months in 2019. Fifty samples were collected from patients suffer from conjunctivitis by fine swab. Isolates were cultured in different media agar media and biochemical tests were used for identifications. The demographic data was collected by a questionnaire filled by the patient after verbal consent. Antibiotic susceptibility testing was conducted by the disc diffusion method (Kirby-Bauer) was performed as recommended by the CLSI. Staphylococcus aureus (ATCC 25923), Escherichia coli (ATCC 25922), and Pseudomonas aeruginosa (ATCC27853) were used as controls. The positive frequency samples were 38 (76%), and the negative samples were 12(24%). Among the 38 positive samples 19(50%) were females while 19(50%) were males. The difference was not significant P= 0.241) with highly infected age groups (1-10) years old. Our Results detected that Some Isolated bacteria developed resistance to certain antibiotics, such as Staphylococcus aureus exhibited resistance against Erythromycin 10/15 (66.7%).While Staphylococcus epidermidis resistant against Tetracycline, and Erythromycin 4/4 (100%). Also, Bacillus spp revealed resistance against Ceftazidime1/1(100%). Listeria monocytogenes was resistant against Ceftazidime and Erythromycin 1/1(100%).On the other hand Pseudomonas aeruginosa, klebsiella pneumonia and klebsiella oxytoca exhibited resistance against Amoxicillin clavulanic acid and Erythromycin. The record data of risk factors conducted by highest frequency include antibiotics (16(36%); P=0.874) and using makeup and viral infection 11(22%); P=0.142) followed by eye surgery, arthritis 6 (12%); P=0.145), diabetes mellitus and hypertension 5(13.2%) ; P=0.654), using the immunosuppressive drug, lens and eye injury 4(8%) ; P=0.654), Smoking (3(6%) ; P=0.961) and heart disease 1(2%) ; P=0.322) associated with conjunctivitis statistically in significant. According to the results, we obtained that the main bacteria that caused conjunctivitis were Staphylococcus aureus and Pseudomonas aeruginosa. The sensitivity test indicated that Ciprofloxacin, Ceftazidime and Gentamycin were the most effective than other drugs used against isolates identified in this study.
References
Pippin MM, Le JK. Bacterial Conjunctivitis. StatPearls. Treasure Island (FL)2020.
Palanisamy S, Mathews AD, Murthy SI. A cute bilateral conjunctivitis with nasooral involvement: A rare manifestation of tuberculosis. Indian J Ophthalmol. 2020;68(4):639-40.
Belga S, Gratrix J, Smyczek P, Bertholet L, Read R, Roelofs K, et al. Gonococcal Conjunctivitis in Adults: Case Report and Retrospective Review of Cases in Alberta, Canada, 2000-2016. Sex Transm Dis. 2019;46(1):47-51.
Zhang S, Hu Q, Deng Z, Hu S, Liu F, Yu S, et al. Transmissibility of acute haemorrhagic conjunctivitis in small-scale outbreaks in Hunan Province, China. Sci Rep. 2020;10(1):119.
Baab S, Le PH, Kinzer EE. Allergic Conjunctivitis. StatPearls. Treasure Island (FL)2020.
Bencharki Y, Bouzouba T, Tamym B, Berraho A. [Viral conjunctivitis due to molluscum contagiosum in a young immunocompetent woman]. J Fr Ophtalmol. 2020.
Treister AD, Kraff-Cooper C, Lio PA. Risk Factors for Dupilumab-Associated Conjunctivitis in Patients With Atopic Dermatitis. JAMA Dermatol. 2018;154(10):1208-11.
. Kruse A, Thomsen RW, Hundborg HH, Knudsen LL, Sorensen HT, Schonheyder HC. Diabetes and risk of acute infectious conjunctivitis--a population-based case-control study. Diabet Med. 2006;23(4):393-7.
Kole E, Pugliese A, Cunha BA. Meningococcal conjunctivitis. Heart Lung. 1992;21(1):94-7.
Tsai CY, Huo AP, Chou CT, Wu TH, Tsai YY. Hepatitis, cholangitis, pulmonary hypertension, digital gangrene, and conjunctivitis sicca in a woman with anticentromere antibodies. Eur J Intern Med. 2006;17(5):360-2.
Lacoste MG, Cargnelutti DE, Tamashiro H, Di Genaro MS. Reactive arthritis with conjunctivitis, urethritis and diarrhea in a child: immunological study of potential bacterial trigger. Clin Exp Rheumatol. 2008;26(2):381-2.
. Dogan U, Agca S. Investigation of possible risk factors in the development of seasonal allergic conjunctivitis. Int J Ophthalmol. 2018;11(9):1508-13.
Hazin R, Elia CJ, Putruss M, Bazzi A. Optic nerve injury in a patient with chronic allergic conjunctivitis. Case Rep Neurol Med. 2014;2014:928486.
Francis IC, Lawless MA. Bilateral giant papillary conjunctivitis related to glaucoma drainage surgery blebs. Cornea. 1994;13(5):469.
Li Y, Huang C, Yang X, Zhang X. Ofloxacin laden microemulsion contact lens to treat conjunctivitis. J Biomater Sci Polym Ed. 2020:1-14.
Ahmed AaH, B Profile of Bacterial Conjunctivitis in Sudan. Sch J App Med Sci. 2016;4(48):1217-12211.
Almajeed AAA, Bushara E, Omer NeT, Ibrahim OM, Ibrahem GMJJBP. Non Chlamydial Acute Bacterial Conjunctivitis in Sudanese Children. 2015;6(253):2.
Alrasheed SH, Naidoo KS, Clarke-Farr PCJAV, Health E. Prevalence of visual impairment and refractive error in school-aged children in South Darfur State of Sudan. 2016;75(1):1-9.
Sahu DN, Thomson S, Salam A, Morton G, Hodgkins P. Neonatal methicillin resistant Staphylococcus aureus conjunctivitis. Br J Ophthalmol. 2006;90(6):794-5.
Ahmed OB, Hamdan EMJSJAMS. Profile of bacterial conjunctivitis in Sudan. 2016;4(4B):1217-21.
Morrow GL AR. Conjunctivitis. American family physician. 1998;57(4):735-46
Olatunji F FA, Ayanniyi A, Akanbi A. Nongonococcal bacterial agents of conjunctivitis and their antibiotic susceptibility patterns in Ilorin. Nigeria Afr J Med Med Sci. 2007;36(3):243-7.
Adebayo A PJ, McCormick SA, Shah MK,Huerto RS, Yu G, Milman TS. . hifting trends in in vitro antibiotic susceptibilities for common bacterial conjunctival isolates in the last decade at the New York Eye and Ear Infirmary. Graefe's Archive for Clinical and Experimental Ophthalmology,. 2011;249(1):111-9.
Abdullah FE KM, Waheed S; . Pakistan journal of medical sciences, 2013;29(1):81. Current pattern of antibiotic resistance of clinical isolates among conjunctival swabs. Pakistan journal of medical sciences. 2013;29(1):81.
Michael A BJT. The Etiology and Antibiogram of Bacterial Causes of Conjunctivitis among Patients Attending the Eye Clinic at Rugarama Hospital in South Western Uganda. An International Journal, . 2014;2014(6):378-83.
Okesola A SA. Microbiological profile of bacterial conjunctivitis in Ibadan, Nigeria. Annals of Ibadan postgraduate medicine, . 2010;8(1):20-4.
Blanco C NMX. Antibiotic Susceptibility of Staphylococci Isolates from Patients with Chronic Conjunctivitis: Including Associated Factors and Clinical Evaluation. Journal of Ocular Pharmacology and Therapeutics,. 2013;29(9):803-8.
Khan M KN, Saeed N, Gulab A, Nazeer A; . A study of 530 cases of vernal conjunctivitis from the North West Frontier Province of Pakistan. Pakistan J Ophthalmol. 1986;2(4):111-4. .
Balasopoulou A KP, Pagoulatos D, Plotas P, Makri OE, Georgakopoulos CD, et al. . Alpha molecular epidemiological analysis of adenoviruses from excess conjunctivitis cases. BMC Ophthalmol. 2017;17(1):51.
]30] Mataftsi A KS, Papagianni E, Tsonona V, Mavridou E, Ziakas N, et al. . Eye Contact Lens. Management of Bacterial Conjunctivitis in Children-Preferred Practice Pattern in Northern Greece. 2018;44(1):S373-S4.
Hedberg K RT, Soler JT, White KE, Hedberg CW, Osterholm MT, et al. . Outbreak of erythromycin-resistant staphylococcal conjunctivitis in a newborn nursery. Pediatr Infect Dis J. 1990;9(4):268-73.
Sthapit P TN, Marasini S, Khoju U, Thapa G;. Bacterial conjunctivitis and use of antibiotics in Dhulikhel Hospital-Kathmandu University Hospital. Kathmandu University Medical Journal. 2012;9(2):69-72. .
Copyright (c) 2022 Omdurman Islamic University Journal

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.