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Please use this identifier to cite or link to this item: http://hdl.handle.net/123456789/529

Advisors: Dr.Yimtubeznash W/amanuel
Dr.Amanuel Haile
Dr.Yonnas Tilahun
Keywords: External ocular infections
antimicrobial sensitivity testing
Copyright: 2004
Date Added: 16-Apr-2008
Publisher: Addis Ababa University
Abstract: External eye infection is an important public health problem in Ethiopia. The knowledge of the etiologic agents causing these infections is crucial in proper management of the cases. There is a scarcity of published data on the spectrum of etiologic agents responsible for external ocular infections in Ethiopia. We conducted a cross sectional study to determine the spectrum of etiologic agents in external ocular infections in two ophthalmic units in Addis Ababa and their susceptibility pattern to commonly used antimicrobial agents. Between November 2003 and March 2004, 485 informed and consented patients coming to the ophthalmologic Units of, Police Force Hospital and Minilik II Memorial Hospital Addis Ababa were included in the study. Majority of patients were from Addis Ababa (85.1%). After physical examination, samples were taken using aseptic techniques, and transported to Tikur Anbessa Specialized hospital, Microbiology Laboratory. All samples were cultured on appropriate media and subsequent identification was done based on morphology and biochemical tests. Susceptibility pattern of the isolated strains to 12 antibiotics using the agar diffusion method was performed. Conjunctivitis was the most prevalent clinical presentation 299(61.6%), followed by, blepharitis 47(9.7%), dacryocystitis 44 (9.1%) keratitis 35 (7.2), blepharoconjuctivitis 21 (4.5%), Lid abcess19 (4.1%), external hordeolum 14 (2.7%) and others 6 (1%). Out of the total number of patients seen 46% were on treatment prior to coming to the hospital. Four hundred eighty five samples were processed for culture and a total of 235 strains were isolated, with a positive culture yield of 47.4%. The most common etiologic agents isolated from both hospitals were S. aureus 57(24.3 %), followed by S. pnuemoniae 49 (21%), Coagulase-negative staphylococci 25(10.6%), H. influenzae 22 (9.4%), Psuedomonas spp 20(8.5%), H. aegyptius 12 (5.1%), K. pneumoniae 11 (4.7%), Moraxella spp 8 (3.4%), N. meningitides 4 (1.7%) and other bacteria 15 (6.3%). The gram-positive bacteria constituted 136 (57.9 %) of the total bacterial isolates. The fungal pathogens isolated were Fusarium spp 3 (1.3%) and Aspergillus fumigatus 3 (1.3%) followed by C. albicans 1(0.4 %). All the fungal pathogens were isolated from keratitis cases, except for one Aspergillus isolate from a case of blepharitis. Rate of susceptibility for gram positives from Minilik II Memorial hospital ranged from 28% to 88% and for gram negatives from 36% to 99.8%. And from Federal Police hospital for gram positives ranged from 30.8% to 97.1%, and for gram negatives 46% to100%. All strains from both hospitals were susceptible to ciprofloxacin. In general rates of susceptibilities to all antibiotics tested for gram positives were lower as compared to gram negatives. Gram-positive bacteria from Federal Police hospital showed a high rate of resistance to commonly used antimicrobial drug ampicillin (69.2%), tetracycline (63.2%) and chloramphenicol (58.8%). More than 75 % of the Pseudomonas isolates from this study were resistant to almost all antibiotics tested except for ciprofloxacin, gentamicin and norfloxacin. There fore we conclude that the knowledge of the etiologic agents and a prompt choice of appropriate antimicrobial agent are very important to success in the management of microbial infections of external ocular in our setting.
Description: A Thesis Presented To The School of Graduate Studies of Addis Ababa University In Partial Fulfillment of the Requirements for the Degree of Masters of Science in Medical Microbiology.
URI: http://hdl.handle.net/123456789/529
Appears in:Thesis - Medical Microbiology

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