2007 OMIG, Abstract 8

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Evidence for Propionibacterium acnes as a Conjunctival Pathogen.
D. W. Stroman, J. G. Bartell, B. A. Schlech
Alcon Research, Ltd., Fort Worth, TX

Purpose: P. acnes is a generally accepted causative agent in endophthalmitis, although there are very few reports of P. acnes being recovered from bacterial conjunctivitis. Schrbereiter-Gurtner et al (2001) detected P. acnes by PCR of 16S rRNA from 10% of conjunctival swabs. The purpose of this study was to determine the frequency of recovery of P. acnes from conjunctival swabs in a multi-center clinical study using appropriate techniques.
Methods: The transport media used to ship the conjunctival swabs to the central laboratory after collection of the specimen was ACT Special Transport Media (Remel, Lenexa, KS) was crucial to the recovery of P. acnes. Inoculated recovery media was incubated anaerobicly for 7 days at 35ºC. Susceptibility testing was performed using E-test strips.
Results: P. acnes was recovered from 76 of 351 (21.6%) culture-positive conjunctivitis patients. From the 258 culture-positive patients aged 6 months to 19 years, P. acnes was recovered from 32 (12.4%); from 72 patients ages 20 years to 49 years, P. acnes was recovered from 38 (52.8%). The rate of resistance to trimethoprim was 37.5% in the young patients and 23.1% in the adult patients; to macrolides (erythromycin and azithromycin) was 18.8% in the young patients and 10.3% in the adult patients; and no resistance to fluoroquinolones in either group of patients. P. acnes was recovered from 6 of 21 (28.8%) of culture-positive patients above 50 years of age. In these 6 patients, the rate of resistance to trimethoprim was 67%; to macrolides was 50%, and to ofloxacin was 17%.
Conclusions: If proper transport and recovery procedures are used, P. acnes is one of the most common bacteria recovered from conjunctivitis patients, especially in the adult patients. The rate of resistance to timethoprim and macrolides is highest among the young patients. Resistance to second-generation FQs is very low in P. acnes recovered from conjunctivitis patients.

Disclosure code: E

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