Significance of normal conjunctival flora in diabetic versus healthy individuals

Abstract

Introduction: Conjunctival sac is constantly exposed to theenvironment. It is more prone to colonization with various microorganisms, which are considered as normal ocular flora. The conjunctival flora in diabetic subjects may differ from that in the nondiabetic subjects. Hence the present study was conducted to determine the flora of conjunctiva in diabetic patients and non diabetics.

Materials and Methods: A total of 100 patients were enrolled in the study. On the basis of history and glycemic status, 55 patients were included in the diabetic group and another 45 patients were included in thenon-diabetic group. Conjunctival swabs were collected and inoculated on bacteriological media (blood agar and chocolate agar) and mycological media (Sabourauddextrose agar). Inoculated bacteriological (37o C) and mycological media (25o C) were incubated for 48 hours and 2-4 weeks respectively and microbial colonies were identified after isolation as per standard microbiological procedures.

Results: Microbial growth yielded from the conjunctival swabs in the diabetic patients was 67.27% and in the non diabetic individuals it was 46.67% .The most common isolated bacteria in diabeticand non diabetic groups was Staphylococcus epidermidis, which accounted for 40.54% and 38.10% respectively. S.aureus was the second most common organism which accounted for 18.91% in diabetics and 14.29% in non diabetics. Candida species was isolated in diabetic group, but not from non diabetic group.

Conclusion: It is essential to differentiate the conjunctival microbial flora in normal healthy individuals and patients who are undergoing ocular surgery. The presence of microbial pathogen leads to an idea of microbial flora and antimicrobial susceptibility tests, which helps in the preoperative and post operative antimicrobial prophylactic therapy.