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| ARTICLES |
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| Year : 1989 | Volume
: 37
| Issue : 2 | Page : 94-95 |
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Microbiological studies in conjunctivitis
AN Boralkar, PR Dindore, RP Fule, BN Bangde, MV Albel, AM Saoji
Professor of Microbiology, V.M. Medical College, Solapur-413003, India
Correspondence Address:
A M Saoji
Professor of Microbiology, V.M. Medical College, Solapur-413003
India
 Source of Support: None, Conflict of Interest: None  | Check |
PMID: 2583792 
A total of 102 cases of clinically diagnosed cases of acute conjunctivitis were included in the present study. The sample was collected from the inflamed conjunctiva and was subjected to conventional bacterial and fungal cultural studies. The allergic element was found out by studying the smear after Giemsa staining and demonstrating increased number of eosinophils. The data revealed that 32 samples had an evidence of bacterial infection, 14 showed isolation of fungi and one displayed an allergic etiology. Thirty cases showed presence of mixed infection in different combinations while 25 samples were sterile on conventional culture media. Microbiological studies are essential for confirmation of clinical diagnosis' and to institute an appropriate treatment.
How to cite this article:
Boralkar A N, Dindore P R, Fule R P, Bangde B N, Albel M V, Saoji A M. Microbiological studies in conjunctivitis. Indian J Ophthalmol 1989;37:94-5 |
| Introduction | |  |
The conjunctival sac is generally sterile at birth but subsequent to its exposure to the external environment and its proximity with the skin it is populated with different microorganisms. Amongst these the saprophytic organisms are common. Inflammation of the conjunctiva is very often noticed because of the local irritation by bateriae, fungi and viruses. The incidence of allergic conjunctivitis is steadily increasing because of exposure to potential allergens. Deveopment of conjunctivitis is fairly common in the immunodeficient individuals, particularly those who have poor hygienic status. The present study is confined to 102 clinically suspected cases of acute conjunctivitis subjected to bacterial and fungal cultures.
| Material and Methods | | |
A total of 102 clinically diagnosed cases of acute conjunctivitis attending the out patient department of Dr. V.M.Medical College, Solapur were included in the present study. A sterile cotton swab moistened with sterile physiological saline was used for collection of the sample from the inflammed conjunctiva. A smear was prepared as a routine and subjected to both Gram and Giemsa staining. The swabs were innoculated on blood agar, chocolate agar and MacConkey's agar and incubated at 37°C for 24 hours. The identification of the bacterial strain was done by studying colony character, biochemical reactions and serotyping by using appropriate antisera. Antimicrobial sensitivity test was carried out according to the conventional disc diffusion method of Bauers et al [4] . The scrapings from the inflamed conjunctiva were obtained by sterile scoop, subjected to Giemsa staining and examined especially for the presence of eosinophils and ruptured granules to diagnose an allergic type of conjunctivitis. The smear was also scrutinised for the presence of inclusion bodies characteristic of different chlamydial infections.
For the identification of fungus, a wet mount from the lesion was done as a routine and subjected to lactophenol-cottonblue staining procedure and examined for the morphological details. The isolation of fungus was done by inoculating a plain Sabouraud's agar and chloramphenicol and cycloheximide incorporated agar and both incubated at 25°C and at 37°C for a maximum of 4 weeks. The ultimate characterisation was done by studying the colony character and the morphological peculiarities of the growing fungus when studied by the conventional lactophenol-cotton-blue staining procedure.
| Observations and Discussion | | |
Amongst the 102 cases of acute conjunctivitis 32 showed an evidence of bacterial infection, 14 revealed presence of fungi, while one showed abundance of eosinophils suggesting an allergic element. A mixed bacterial and fungal infection was observed in 22 cases, three cases showed combination of bacterial and allergic etiology, while two displayed a fungal and an allergic combination. In three cases evidence of bacterial, fungal and allergic etiology was noticed. As many as 25 samples were sterile when studied on different conventional cultural media.
The data revealed that as many as 60 samples had a bacterial etiology either singly or in combination. The distribution of the isolates was as follows : coagulase-negative staphylococci (12), Staphylococcus aureus (8), micrococci (7), Pseudomonas (6) and others (20) [Table - 1]. The findings were comparable with the study of Sinha and Das [5] .Prentice et al [6] and Prabhakar et al [7]. The reported incidence of isolation of coagulase negative Staphylococci in diseased eyes range from 21 to 61 percent [5],[6] . The isolation of bacillus species in the present study is on a higher side when compared with other published studies 7. The isolation of Corynebacterium diphtheriae is extremely rare in the pathogenesis of acute conjunctivitis [8] . We have reported this pathogen in one case and confirmed its virulence by in vivo and in vitro procedures [9] .
The mycotic culture study revealed that as many as 41 isolates had an evidence of fungal infection in varying combination [Table - 2]. The isolation rate is comparable with that noticed in other studies [2],[5],[7],[10] . Allergic etiology was noticed in a solitary case and it was associated with some infective etiology (bacterial or fungal) in 8 cases.
The incidence is on a lower scale when compared with the study of Friedlader et al (1984) [3] . The microbiological studies are essential for the confirmation of clinical diagnosis and to institute an appropriate antimicrobial theraphy. It should however,be remembered that the mixed infections being common, pathogenesis may not be ascribed to a specific isolate in a given case. Since the patients were managed at the out patient department, follow up was not feasible in the present study.
| References | | |
| 1. | Cason : Bacteriology of the eye . Normal flora. Arch. Ophthal; 51:196-199,1954.  |
| 2. | Pavan - Langston D : Diagnosis and theraphy of common eye infections : bacterial, viral and fungal. Compr The; 9: 33-42,1983. |
| 3. | Friedlaender,M.H.,Okumoto,M.andKelley,J:Diagnosis of allergic conjunctivitis. Arch. Ophthal; 102:1198-1999,1984. |
| 4. | Agarwal, K.C : Antibiotic sensitivity test by disc diffusion method : standardization and interpretation. Ind J Path Bact., 17 : 149,1974. |
| 5. | Sinha, B.N. amd Das, M.S. : Bacterial and fungal flora of the conjunctival sacs in healthy and diseased eyes. Jour of Ind Med Ass., 51 (5) : 217-222, 1968. |
| 6. | Prentice, MJ., Hutchison, G.R.and Robinson, D.T. : A microbiological study of neonatal conjunctivae and conjunctivitis. Brit Jour Ophthal,61(9):601-607,1977. |
| 7. | Prabhakar, IL, Chitkara, N.L and Prabhakar, BR. : Mycotic and bacterial flora of the conjunctival sacs in healthy and diseased eyes. Ind. Jour. Path and Bact : 12:158-161,1969. |
| 8. | Coachman, E.H. : Bilateral circumlimbal ulcers from malignant diphtheria. Am J OpthalmoL, 34: 1176,1951. |
| 9. | Boralkar A.N., Dindore, P.R., Fule, R.P., Bangde, B.N., Alba;. M.V.and Saoji, A.M.: Diphtheritic conjunctivitis-A rare case report in Indian literature (Under publication) |
| 10. | Nobuyo : Fungi of the conjunctival sac. Am Jr. of Ophthalmol. 94:67, July, 1982. |
[Table - 1], [Table - 2]
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