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2003 OMIG, Abstract 18

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The Microbial Flora From Explanted Punctal Plugs
Sarkis H.Soukiasian. Department of Ophthalmology, Lahey Clinic, Burlington, MA

Purpose: To describe the microbial flora from explanted silicone punctal plugs.
Methods: Retrospective review of microbial cultures of 20 punctal plugs explanted from 16 symptomatic patients for a variety of reasons including discomfort, epiphora, conjunctival injection, worsening keratitis, and mucoid discharge.
Results: Positive cultures were obtained from 19 plugs (95%). A single organism was identified from 10 plugs, with 9 plugs having more than one organism. Ps. aeruginosa (Ps.) being the most frequent isolate in 35%(7). The next most common isolates were S. aureus (20%(4)), CNS (15%(3)) and alpha hemolytic strep (15%(3)). Other organisms identified included Serratia (10%(2)), Stenotrophomonas (10%(2)), and single cases of Klebsiella, Moraxella, Aspergillus, Candida and Citrobacter.
Conclusion: A high incidence of Ps. and other gram negative organisms was identified. This may be due to colonization by potential pathogenic species with the formation of bacterial biofilm on punctal plugs and may account for clinical symptoms and findings.

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