الفهرس 
Microbial FloraOnly 14 pages are availabe for public view
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Abstract
E
yelids and conjunctiva harbor a significant number of bacteria from the external environment and are called normal flora. They play an important role in normal body functions and health by secreting antibiotics and chemical mediators to maintain surface homeostasis and immunoregulation. They prevent colonization by pathogenic organisms.
Some members of the conjunctival flora play a pathogenic role in diabetes mellitus when immune function is compromised, which may lead to serious infection.
Diabetic patients are prone to develop infection including eye infections. Common eye infections in diabetics are blepharitis, conjunctivitis, keratitis, stye, chalazion and orbital cellulitis. It was reported that diabetic patients have higher levels of glucose in their tears than the nondiabetics which may contribute to development of ocular infections. The conjunctival flora in diabetic subjects may differ from that in nondiabetic subjects.
The present study aimed to detect the presence of pathogenic bacteria other than floral bacteria which are important pathogens of ocular infections in diabetic patients which may lead to development of better treatment regimens.
This cross sectional descriptive study conducted in the Ophthalmology Department and Microbiology Department of AIN Shams University Hospitals, from1November to 15 December 2020. The report is based on bacteriological culture results of healthy conjunctiva of diabetic retinopathy patients visiting the Eye Outpatient Department. The study populations were 60 normal eyes of 60 diabetic retinopathy patients.
All the participants were examined, vision was assessed by Snellen chart, and slit-lamp examination of the anterior and posterior segment was performed. Patients with any active ocular infection and using topical antibiotics were excluded.
Then collected conjunctival samples from either eyes separately with a sterile cotton tipped swab moistened in normal saline by rubbing them over the lower conjunctival sac from medial to lateral canthus and back again to the medial canthus very carefully without touching the cornea or eyelid. The swabs were then inserted into separate sterile labeled test tubes and transported immediately to microbiology laboratory.
Swabs were directly inoculated onto blood agar, chocolate agar, and MacConkey agar. All Agar were examined after 48h. The colonies were then extracted for Gram staining and categorized into gram positive cocci, gram negative cocci, gram positive bacilli and gram negative bacilli. Catalase test was done for cocci to distinguish from Staphylococcus (catalase +ve) from Streptococcus (catalase -ve). Coagulase tests were done for identification of different species of Staphylococcus, coagulase positive Staphylococcus aureus (the pathogenic strains) and the coagulase negative Staphylococcus species (the nonpathogenic strains).
Among 60patients, 26 were males and 34were females, 35 had NPDR (58%), 25 had PDR (44%), 24 on OHG (40%) 36 on insulin (60%)
Growth of some bacteria was seen in 29 patients (48.3%) in total of 60 eyes. The commonest flora isolated was coagulase negative staphylococcus (CONS) 31.7%, next was candida 16.7%.
57.77% of male subjects had sterile conjunctiva compared to 47.1% in the females. The swab culture of rest of the subjects showed that CONS was the predominant normal flora in both, 30.8% and 32.4% in males and females respectively. However candida species was found significantly high in females 23.5%
Positive conjuctival culture was found higher in patients on insulin than OHG, however Staph Cong, non-hemolytic streptococcus, candida were found higher in patients on insulin therapy but there were of no statistical significance, candida was found higher in stage of NPDR than PDR and had a statistical significance.
There was no statistical significance correlation between culture results and duration of diabetes.
Mean age were found higher in PDR patients than NPDR patients and NPDR patients were found higher in females. VA was found better in NPDR patients than PDR patients and PDR patients had an association with increase duration of diabetes.