##article.abstract##
Infective endophthalmitis can follow contamination from eyelid of surgical eye patients. Information about peri-ocular skin bacterial isolates and their determinants would help in planning appropriate interventions. This study aimed to determine the upper lid skin bacterial count and factors related to high counts if any, among surgical eye patients. A cross section of consenting new surgical eye patients seen at the Eye clinic of the University College Hospital Ibadan between May and July 2006 was studied. They were interviewed with a standard questionnaire, and swab of the upper eyelid skin taken. Specimens were Gram-stained, bacterial counts and culture were carried out using standard techniques. A total of 80 subjects were studied, age range 13 to 87 years (mean 57.8 +/-15.8 ) years. Females were 42 (52.5%) while males were 38 (47.5%). Bacterial culture was obtained from 76 (95.0%) of those studied, with 24 (30.0%) having Staphylococcus aureus sensitive to gentamycin and amoxicillin + clavulanic acid combination while 52 (65.0%) had coagulase negative Staphylococcus. The mean bacterial count was 218 +/- 321 colony forming units (CFUs) per ml. Higher bacterial counts ( > 50 CFUs per ml) were found amongst non-literates, patients older than 60 years of age, and male gender. Older age and male gender remained significantly associated with a high bacterial count using the logistic regression model (OR= 4.9, P=0.03 and OR =8.06, P=0.005 respectively). The conclusion reached was that risk of having positive bacterial culture from the upper lid skin increases with older patient age and male sex of eye surgery patients. Adequate care should be taken to ensure proper skin preparation of elderly and male patients to prevent contamination of operation site.
Keywords: Bacterial isolate, flora, eye surgery
Résumé
Endolphthalmite infectieux peut suivre par la contamination après la chirurgie des paupières des yeux des patients. Information a propos la peau peri-occulaire dans la planification des interventions appropriées. Cette étude a pour but de déterminer le taux de bactéries de la peau de la paupière supérieure et si possible les facteurs liés au taux élevé, parmi les chirurgies des yeux aux patients vus en clinique oculaire au Centre Universitaire Hospitalier d’Ibadan entre Mai –Juillet 2006. Ils étaient interviewés avec un questionnaire standard et les prélèvements obtenus de la paupière supérieure. Les échantillons étaient teintés, les taux bactérien évalués suivi d’une culture effectué avec des techniques standard. Un total de 80 sujets étaient étudiés dans la tranche d’age de 13 à 87 ans avec 38(47,5%) d’homme. La culture bactérienne était obtenu de 76(95,0%) de ceux étudiés, avec 24(30,0%) ayant le staphylocoque aureus sensible a la gentamicine et a la combinaison de l’amoxiciline plus acide clavulanique pendant que 52(65,0%) ont un staphylocoque négatif coagulase. le nombre moyen de bactérie étaient de 218 ± 321 unité de colonies formes (UCF) par ml. Cette étude démontrait que parmi les patients âgés de plus de 60 ans et significativement au nombre élevé de bactérie utilisant le model de régression logistique (OR=4,9 ; P=0,03 et OR=8,06 ; P=0,005 respectivement). Nous concluons que le risque d’avoir une culture positive de bactéries de la paupière supérieure augmente avec l’age des patients et la chirurgie des yeux des patients de sexe masculin. Les soins adéquats doivent être pris pour assurer la bonne préparation de la peau des Apatients masculins âgés pour prévenir la contamination du site de la chirurgie.
Correspondence: Dr. C.O. Bekibele, Department of Ophthalmology, College of Medicine, University of Ibadan, University College Hospital, Ibadan, Nigeria. Email: cob150@yahoo.com
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