Upper lid skin bacterial count of surgical eye patients in Ibadan, Nigeria

Abstract

Infective endophthalmitis can follow contamination from eyelid of surgical eye patients. Information about peri-ocular skin bacterial isolates and their determinants would help in planning appropriate interventions. This study aimed to determine the upper lid skin bacterial count and factors related to high counts if any, among surgical eye patients. A cross section of consenting new surgical eye patients seen at the Eye clinic of the University College Hospital Ibadan between May and July 2006 was studied. They were interviewed with a standard questionnaire, and swab of the upper eyelid skin taken. Specimens were Gram-stained, bacterial counts and culture were carried out using standard techniques. A total of 80 subjects were studied, age range 13 to 87 years (mean 57.8+/-15.8 ) years. Females were 42 (52.5%) while males were 38 (47.5%). Bacterial culture was obtained from 76 (95.0%) of those studied, with 24 (30.0%) having Staphylococcus aureus sensitive to gentamycin and amoxicillin + clavulanic acid combination while 52 (65.0%) had coagulase negative Staphylococcus. The mean bacterial count was 218 +/- 321 colony forming units (CFUs) per ml. Higher bacterial counts (> 50 CFUs per ml) were found amongst non-literates, patients older than 60 years of age, and male gender. Older age and male gender remained significantly associated with a high bacterial count using the logistic regression model (OR= 4,9. P=0.03 and OR =8.06, P=0.005 respectively). The conclusion reached was that risk of having positive bacterial culture from the upper lid skin increases with older patient age and male sex of eye surgery patients. Adequate care should be taken to ensure proper skin preparation of elderly and male patients to prevent contamination of operation site.