Microbiological Evaluation of Blepharitis: A Case-Controlled Study

  • Sourat Mudassar University of the Punjab, Lahore, Pakistan
  • Abida Bano University of the Punjab, Lahore, Pakistan
  • Maryam Shahid University of the Punjab, Lahore, Pakistan
  • Farah Asghar University of the Punjab, Lahore, Pakistan
  • Fadia Waheed University of the Punjab, Lahore, Pakistan
  • Numan Javed University of the Punjab, Lahore, Pakistan
Keywords: antibiotics, antibiotic susceptibility testing (AST), blepharitis, Gram-positive bacteria, methicillin resistant Staphylococcus aureus (MRSA), vancomycin

Abstract

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Background. Blepharitis is a chronic inflammatory eyelid infection. The current study was designed to check the association of normal bacterial flora of normal eyelids with the potential pathogenic bacteria of blepharitis infected eyelids of blepharitis patients.

Methodology. A total of (n=50) blepharitis patients were recruited for this study. Then, 100 swab samples were taken from these patients. Sample distribution indicated that 50 swab samples were taken from infected eyelids and 50 from the uninfected part of eyelids of blepharitis patient. Bacterial flora was characterized in these samples through different biochemical tests and antibiotic resistance was checked by using the Kirby Bauer (KB) method.

Results. A total of 52 bacterial strains were isolated from 50 infected swab samples of 50 blepharitis patients including Staphylococcus aureus 31/52 (60%), Staphylococcus epidermidis 7/52 (13%), Klebsiella spp. 6/52 (11%), E. coli 2/52 (4%), Acinetobacter spp. 2/52 (4%), Enterobacter spp. 1/52 (2%), Serratia marcescens 1/52 (2%), Shigella spp. 1/52 (2%) and Bacillus cereus 1/52 (2%). Further, 48 bacterial strains were isolated from uninfected swab samples of 50 blepharitis patients including Staphylococcus epidermidis 24/48 (50%), Staphylococcus aureus 22/48 (42%), Klebsiella spp. 1/48 (2%), Enterobacter spp. 1/48 (2%), Serratia spp. 1/48 (2%), and Acinetobacter spp. 1/48 (2%). All Gram-positive bacteria isolated from both infected and uninfected eyelids were found to be sensitive to vancomycin antibiotics. The percentage of methicillin-resistant Staphylococcus aureus (MRSA) was 21% among the bacterial isolates obtained from infected eyelids. While, its percentage was 18.7% in the bacterial isolates obtained from the uninfected eyelids of the patients. Hence, the percentage of MRSA was higher in the infected eyelids of blepharitis patients as compared to their uninfected eyelids.

Conclusion. The identification of pathogens involved in blepharitis and performing their antibiotic susceptibility test (AST) are important steps in reducing bacterial resistance for blepharitis treatment.

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References

Ruan F, Zang Y, Sella R. Intense pulsed light therapy with optimal pulse technology as an adjunct therapy for moderate to severe blepharitis-associated keratoconjunctivitis. J Ophthalmol. 2019;2019:e3143469. https://doi.org/10.1155/2019/3143469

Murray JJ, Hou JH. Anterior blepharitis. In: Farooq AV, Reidy JJ, eds. Blepharitis. Essentials in Ophthalmology. Springer; 2021:1–7. https://doi.org/10.1007/978-3-030-65040-7_1

Di Zazzo A, Giannaccare G, Villani E, Barabino S. Uncommon blepharitis. J Clin Med. 2024;13(3):e710. https://doi.org/10.3390/jcm13030710

Nejima R, Eguchi H, Todokoro D, et al. Analysis of treatment protocols using azithromycin eye drops for bacterial blepharitis: second report—bacteriological investigation. Jpn J Ophthalmol. 2022;66(6):579–589. https://doi.org/10.1007/s10384-022-00947-8

Putnam CM. Diagnosis and management of blepharitis: an optometrist’s perspective. Clin Optom. 2016;2016:71–78. https://doi.org/10.2147/opto.s84795

Siddique AA, Shaheen KH, Raza I, et al. Clinical presentation, risk factors and outcomes of demographic analysis of blepharitis in adults presenting at multiple healthcare centres. Life Sci. 2021;2(4):160–163. https://doi.org/10.37185/lns.1.1.203

Qin RS, Tien LTH. Healthcare delivery in meibomian gland dysfunction and blepharitis. Ocul Surf. 2019;17(2):176–178. https://doi.org/10.1016/j.jtos.2018.11.007

Getahun E, Gelaw B, Assefa A, Assefa Y, Amsalu A. Bacterial pathogens associated with external ocular infections alongside eminent proportion of multidrug resistant isolates at the University of Gondar Hospital, northwest Ethiopia. BMC Ophthalmol. 2017;17:1-10. https://doi.org/10.1186/s12886-017-0548-6

Belyhun Y, Moges F, Endris M, et al. Ocular bacterial infections and antibiotic resistance patterns in patients attending Gondar Teaching Hospital, Northwest Ethiopia. BMC Res Notes. 2018;11:1–7. https://doi.org/10.1186/s13104-018-3705-y

Jin Y, Wang Q, Zhang H, et al. Phenol-soluble modulin contributes to the dispersal of Staphylococcus epidermidis isolates from catheters. Front Microbiol. 2022;13:e934358. https://doi.org/10.3389/fmicb.2022.934358

Wang C, Dou X, Li J, Wu J, Cheng Y, An N. Composition and diversity of the ocular surface microbiota in patients with blepharitis in northwestern China. Front. Med. 2021;8:e768849. https://doi.org/10.3389/fmed.2021.768849

Asghar AH. Molecular characterization of methicillin-resistant Staphylococcus aureus isolated from tertiary care hospitals. Pak J Med Sci. 2014;30(4):698–702. https://doi.org/10.12669%2Fpjms.304.4946

Asghar F, Bano A, Waheed F, Anjum AA, Ejaz H, Javed N. Association of exogenous factors with molecular epidemiology of Staphylococcus aureus in human oral cavity. Saudi J Biol Sci. 2023;30(4):e103613. https://doi.org/10.1016/j.sjbs.2023.103613

Holmes NE, Tong SY, Davis JS, Van Hal SJ. Treatment of methicillin-resistant Staphylococcus aureus: vancomycin and beyond. Semin Respir Crit Care Med. 2015;36(1):17–30. https://doi.org/10.1055/s-0034-1397040

Fernández-Engroba J, Ferragut-Alegre Á, Oliva-Albaladejo G, de la Paz MF. In vitro evaluation of multiple antibacterial agents for the treatment of chronic staphylococcal anterior blepharitis. Arch Spanish Soc Ophthal. 2023;98(6):338–343. https://doi.org/10.1016/j.oftale.2023.05.003

Ejaz H, Javeed A, Zubair M. Bacterial contamination of Pakistani currency notes from hospital and community sources. Pak J Med Sci. 2018;34(5):1225–1230. https://doi.org/10.12669/pjms.345.15477

Pflugfelder SC, Karpecki PM, Perez VL. Treatment of blepharitis: recent clinical trials. Ocul Surf. 2014;12(4):273–284. https://doi.org/10.1016/j.jtos.2014.05.005

Liu R, Cui H, Geng X, et al. Antibiotic delivery system for treating bacteria-induced anterior blepharitis. ACS Infect Dis. 2023;9(10):2005–2015. https://doi.org/10.1021/acsinfecdis.3c00299

Qureshi N, Ahmed T, Ahmed T. Prevalence of ocular problems among school students of Karachi. Pak J Surg. 2016;32(4):264–268.

Fatima T, Tariq A, Qamar A. Prevalence of vitamin A deficiency among children of Lahore, Pakistan. Asian J Multidiscip Stud. 2018;6:62–64. https://doi.org/10.1155/2020/8032894

Deom JE, Cavet ME, Sanfilippo CM, DeCory HH. In vitro potency of tobramycin against common bacterial pathogens implicated in blepharitis. Invest Ophthalmol Vis Sci. 2021;62(8):414–414.

Stroman DW, Mintun K, Epstein AB, et al. Reduction in bacterial load using hypochlorous acid hygiene solution on ocular skin. Clin Ophthalmol. 2017;2017:707–714. https://doi.org/10.2147/opth.s132851

Musa AA, Nazeerullah R, Sarite SR. Bacterial profile and antimicrobial susceptibility pattern of anterior blepharitis in Misurata region, Libya. Dent Med Res. 2014;2(1):8–13. https://doi.org/10.4103/2348-1471.131557

Zhu M, Cheng C, Yi H, Lin L, Wu K. Quantitative analysis of the bacteria in blepharitis with Demodex infestation. Front Microbiol. 2018;9:e1719. https://doi.org/10.3389/fmicb.2018.01719

Khokhlova OE, Hung WC, Wan TW, et al. Healthcare-and community-associated methicillin-resistant Staphylococcus aureus (MRSA) and fatal pneumonia with pediatric deaths in Krasnoyarsk, Siberian Russia: unique MRSA's multiple virulence factors, genome and stepwise evolution. PLoS One. 2015;10(6):e0128017. https://doi.org/10.1371/journal.pone.0128017

Noorulamin MN, Zarafsah ZB, Janjua A, Iqbal A, Humerah S, Shaiq PA. Future trends in the treatment of MRSA in Pakistan. J Islamabad Med Dent College. 2022;11(2):96–102. https://doi.org/10.35787/jimdc.v11i2.672

Mazin OM, Lemya AK, Samah OM. External ocular bacterial infections among Sudanese children at Khartoum State, Sudan. Afr J Microbiol Res. 2016;10(40):1694–1702. https://doi.org/10.5897/ajmr2016.8092

Moriyama AS, Nascimento H, Hofling-Lima AL. Methicilin resistant staphylococcus aureus prevalence in a tertiary eye care center in Brazil. Invest Ophthalmol Vis Sci. 2011;52(14):5845–5845.

Riaz S, Hussain A, Sohail M, Rehman SU, Javed N, Abbas Z. Isolation and characterization of Vancomycin Resistant Staphylococcus aureus (VRSA) from Intensive Care Units (ICU) of different hospitals in Lahore, Pakistan. Adv Life Sci. 2021;8(4):339–344.

Aramă V. Topical antibiotic therapy in eye infections-myths and certainties in the era of bacterial resistance to antibiotics. Rom J Ophthalmol. 2020;64(3):245–260. https://doi.org/10.22336/rjo.2020.42

Koulenti D, Xu E, Mok IYS, et al. Novel antibiotics for multidrug-resistant gram-positive microorganisms. Microorganisms. 2019;7(8):e270. https://doi.org/10.3390/microorganisms7080270

Duncan K, Jeng BH. Medical management of blepharitis. Curr Opin Ophthalmol. 2015;26(4):289–294. https://doi.org/10.1097/icu.0000000000000164

Published
2024-07-18
How to Cite
Mudassar, S., Bano, A., Shahid, M., Asghar, F., Waheed, F., & Javed, N. (2024). Microbiological Evaluation of Blepharitis: A Case-Controlled Study. BioScientific Review, 6(3), 35-48. https://doi.org/10.32350/bsr.63.02
Section
Research Articles