bacteriological profile, culture, sensitivity and associated factors of bacterial conjunctivitis among patients attending the eye clinic at mulago national refferal hospital

Description

Introduction. Conjunctivitis accounts for 30% of all patient visits due to ocular symptoms in United States, and a study done in Pakistan showed its prevalence to be 18.3%. In Africa, few studies have been done. Among these wasone done in Nigeria that showed the prevelance of bacterial conjunctivitis to be 1.1% among ocular morbidities. An estimated 30 million people in Sub-Saharan Africa are affected by conjunctivitis and of these, 60% are self-limiting within one to two weeks. Conjunctivitis poses an increased risk of developing keratitis and Corneal ulcerations which could result into blindness and visual impairment. In sub Saharan Africa and it’s severe complications are a result of poor management, Despite the commonality of the disease in this region, there is a paucity of published literature on the occurrence of bacterial conjunctivitis. This study thus aimed at establishing the bacteriological profile and factors associated with bacterial conjunctivitis among patients attending the MNRH ophthalmology clinic. General objective: : To determine the bacteriological profile,culture,sensitivity and factors associated with bacterial conjunctivitis among patients seen at Mulago National Referral Hospital. Methods: This was a cross-sectional study with 82 participants selected consecutively from The consultants clinic and OCO (Ophthalmic clinical officer) clinic of Mulago National Referral Hospital between January and March 2020. An informed consent was obtained and using a pretested questionnaire, information on socio-demographics and clinical presentation was obtained. A conjunctival swab was taken from each of the patients and thereafter sent for laboratory analysis to establish the bacterial profiles and antibiotic susceptibility. Data was analyzed using Stata 14.0 and results summarized into fequency, proportions, tables,box plot, graphs and bivariate and multivariate levels. Results: A total of 82 participants were recruited to the study. The median age of the participants 30 years (IQR 16-48). More than half of the participants were male 51/82 (62.2%). The proportion of participants with bacterial conjunctivitis was significantly higher among participants aged 10-24.9 years compared to those aged 25 and above (aPR = 1.89, 95%CI 1.18-3.03, p = 0.008). The most common isolated bacteria in this study was S. aureus and the bacteria was generally sensitive to ciprofloxacin with resistant percentages less than 20%. Almost 95% of the bacteria were susceptible to ciprofloxacin and 90% were susceptible to chloramphenicol. Most of the bacteria were found to be resistant to Trimethoprim, penicillin G, co-trimoxazole, ampicillin and augmentin. Conclusion and Recommenadtions: This study showed that of the patients diagnosed with microbial infections at ophthalmology clinics in MNRH, 51% had bacterial conjunctivitis, mainly caused by gram-positive bacteria especially S. aureus. Age was significantly associated with bacterial conjunctivitis. Most of the bacteria that cause conjunctivitis were sensitive to the available antibiotics (chloramphenicol, ciprofloxacin and clindamycin). We recommend that clinicians are critical when diagnosing patients with conjunctival infections to avoid missing out on bacterial conjunctivitis.