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2005 OMIG, Abstract 18

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Bacterial Culture Isolates from Hospitalized Pediatric Patients with Conjunctivitis

Ahmad B. Tarabishy, MD1, Gerri S. Hall, PhD2, Gary W. Procop, MD2, Bennie H. Jeng, MD3

1Department of Internal Medicine, 2Department of Microbiology, 3Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, OH 44195

Purpose: To determine the causative organisms of acute bacterial conjunctivitis in hospitalized pediatric patients at a tertiary care referral center.

Methods: A retrospective chart review was performed evaluating all pediatric patients hospitalized at the Children's Hospital of the Cleveland Clinic Foundation from January 1, 1996 to November 30, 2004 who developed clinical signs of acute bacterial conjunctivitis (red eye with purulent discharge) and had culture-positive conjunctival swabs. The frequency of each bacteria and their susceptibility to antibacterial agents were recorded.

Results: One hundred seven bacterial isolates were cultured from eyes of 59 patients. A single organism was found in 27 (45.8%) patients. The most common organism was coagulase-negative Staphylococcus, found in 59.3% (35 of 59) of patients. Viridans Streptococcus sp. and Staphylococcus aureus were found in 47.5% (28 of 59) and 20.3% (12 of 59) of patients, respectively. Less common organisms included Hemophilus influenzae (17.0%), Pseudomonas aeruginosa (8.5%), and Escherichia coli (6.8%). Among the 42 isolates of coagulase-negative Staphylococcus identified, 26 were tested for antimicrobial susceptibility, and 65.3% (17 of 26) were methicillin-resistant. Similarly, 13 of 13 isolates of Staphylococcus aureus were tested for susceptibility, and 30.8% (4 of 13) were methicillin-resistant.

Conclusions: The distribution of bacterial organisms causing acute conjunctivitis in our hospitalized patients differs from that of previous reports of pediatric patients who present with acute bacterial conjunctivitis in an outpatient setting. In addition, there seems to be a high rate of methicillin-resistance among coagulase-negative Staphylococcus and Staphylococcus aureus isolates in our hospital setting. As opposed to empiric treatment of pediatric acute bacterial conjunctivitis in an outpatient setting, in an inpatient setting where causative organisms may be different and antibiotic resistance may be higher, conjunctival swabbing for culture and susceptibilities may be warranted.

Disclosure Code: N

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