Antibiotic susceptibility and efflux pump activity in uncommon bacterial species associated with conjunctivitis
DOI:
https://doi.org/10.60988/p.v37i2S.233Keywords:
conjunctivitis; antibiotic susceptibility; efflux pumps; uncommon bacteria; common bacteriaAbstract
This study investigates the antibiotic susceptibility and phenotypic characteristics of uncommon bacterial species associated with conjunctivitis. A total of 150 conjunctival swab samples were collected from patients presenting with symptoms of conjunctivitis at the Al-Nasiriyah Teaching Hospital and the Al-Haboubi General Hospital (Ophthalmology Consultant Unit; Dhi Qar Governorate, Iraq) between August and December 2024. Bacterial isolates were identified based on cultural and microscopic characteristics, supplemented by the Vitek® 2 Compact System (bioMérieux, France). Gram-positive bacteria predominated, with Staphylococcus aureus accounting for 40% of isolates. Several uncommon species were also identified, including Kocuria kristinae, Staphylococcus hominis subsp. hominis, Escherichia coli, Brucella melitensis, Gemella bergeri, Staphylococcus pseudintermedius, and Leuconostoc citreum. Antibiotic resistance profiles were determined using the Kirby–Bauer disk diffusion method, revealing notable resistance to commonly prescribed agents such as erythromycin and ciprofloxacin. Efflux pump activity (a key mechanism contributing to multidrug resistance) was detected in 37.5% of isolates using the ethidium bromide cartwheel method. These findings highlight the importance of robust antibiotic stewardship and underscore the need for continuous surveillance of bacterial resistance patterns in order to optimize therapeutic strategies for conjunctivitis.
References
1. Mahoney M.J., Bekibele R., Notermann S.L., Reuter T.G., Borman-Shoap E.C. Pediatric conjunctivitis: a review of clinical manifestations, diagnosis, and management. Children (Basel) 10(5), 808, 2023. DOI: 10.3390/children10050808
2. Al-Buhamrah N., Hussain J., Saadon Q. Detection of aac(3)-I gene in Chlamydia trachomatis isolated from conjunctivitis by using PCR technique in Al-Najaf province, Iraq. Microb. Biosyst. 9(1), 27–32, 2024. DOI: 10.21608/mb.2024.283952.1097
3. Saba C.K.S., Amenyona J.K., Kpordze S.W. Prevalence and pattern of antibiotic resistance of Staphylococcus aureus isolated from door handles and other points of contact in public hospitals in Ghana. Antimicrob. Resist. Infect. Control 6, 44, 2017. DOI: 10.1186/s13756-017-0203-2
4. Blair J.M., Webber M.A., Baylay A.J., Ogbolu D.O., Piddock L.J. Molecular mechanisms of antibiotic resistance. Nat. Rev. Microbiol. 13(1), 42–51, 2015. DOI: 10.1038/nrmicro3380
5. Shaeri M., Nazari-Alam A., Fathizadeh H., Moniri R., Akbari H., Mansoori M., et al. Bacterial etiology and antibiotic susceptibility of conjunctivitis patients’ isolates in Kashan, Iran. Adv. Biomed. Res. 9, 49, 2020. DOI: 10.4103/abr.abr_118_20
6. Baiomy A.A., Shaker G.H., Abbas H.A. Sensitizing multi drug resistant Staphylococcus aureus isolated from surgical site infections to antimicrobials by efflux pump inhibitors. Afr. Health Sci. 20(4), 1632–1645, 2020. DOI: 10.4314/ahs.v20i4.16
7. Kareem Rhumaid A., Alak Mahdi Al-Buhilal J., Al-Rubaey N.K.F., Yassen Al-Zamily K. Prevalence and antibiotic susceptibility of pathogenic bacteria associated with ocular infections in adult patients. Arch. Razi Inst. 77(5), 1917–1924, 2022. DOI: 10.22092/ARI.2022.359510.2437
8. Szemraj M., Glajzner P., Sienkiewicz M. Decreased susceptibility to vancomycin and other mechanisms of resistance to antibiotics in Staphylococcus epidermidis as a therapeutic problem in hospital treatment. Sci. Rep. 13(1), 13629, 2023. DOI: 10.1038/s41598-023-40866-3
9. An N.V., Hai L.H.L., Luong V.H., Vinh N.T.H., Hoa P.Q., Hung L.V., et al. Antimicrobial resistance patterns of Staphylococcus aureus isolated at a general hospital in Vietnam between 2014 and 2021. Infect. Drug Resist. 17, 259–273, 2024. DOI: 10.2147/IDR.S437920
10. Munita J.M., Arias C.A. Mechanisms of antibiotic resistance. Microbiol. Spectr. 4(2), 10.1128/microbiolspec.VMBF-0016-2015, 2016. DOI: 10.1128/microbiolspec.VMBF-0016-2015