Clin. Lab. 11/2014
1879
Clin. Lab. 2014;60:1879-1886
©Copyright
ORIGINAL ARTICLE
Prevalence and Antimicrobial Susceptibilities of
Anaerobic Bacteria Isolated from Perforated Corneal Ulcers by
Culture and Multiplex PCR: An Evaluation in
Cases with Keratitis and Endophthalmitis
HRİSİ BAHAR TOKMAN
1
, GÜZİN İSKELELİ
2
, ZEYNEP GÜNGÖRDÜ DALAR
1
,
ACHİLLE AİME KANGABA
1
, MEHMET DEMİRCİ
1
, HATİCE K. AKAY
1
,
BARIŞ ATA BORSA
3
, REYHAN ÇALIŞKAN ALGINGİL
1
,
BEKİR S. KOCAZEYBEK
1
, MÜZEYYEN MAMAL TORUN
4
, NURİ KİRAZ
1
1
Istanbul University, Cerrahpasa Faculty of Medicine, Department of Medical Microbiology, Istanbul, Turkey
2
Istanbul University, Cerrahpasa Faculty of Medicine, Department of Ophthalmology, Istanbul, Turkey
3
Kemerburgaz University, Faculty of Medicine, Department of Medical Microbiology, Istanbul, Turkey
4
Bahçeşehir University, Faculty of Medicine, Department of Medical Microbiology, Istanbul, Turkey
SUMMARY
Background: Anaerobic bacteria play an important role in eye infections; however, there is limited epidemiologic
data based on the the role of these bacteria in the etiology of keratitis and endophthalmitis. The aim of this re-
search is to determine the prevalence of anaerobic bacteria in perforated corneal ulcers of patients with keratitis
and endophthalmitis and to evaluate their antimicrobial susceptibilities.
Methods: Corneal scrapings were taken by the ophthalmologist using sterile needles. For the isolation of anaerobic
bacteria, samples were inoculated on specific media and were incubated under anaerobic conditions obtained with
Anaero-Gen (Oxoid & Mitsubishi Gas Company) in anaerobic jars (Oxoid USA, Inc. Columbia, MD, USA). The
molecular identification of anaerobic bacteria was performed by multiplex PCR and the susceptibilities of an-
aerobic bacteria to penicillin, chloramphenicol, and clindamycin were determined with the E test (bioMerieux).
Results: 51 strains of anaerobic bacteria belonging to four different genuses were detected by multiplex PCR and
only 46 strains were isolated by culture. All of them were found susceptible to chloramphenicol whereas penicillin
resistance was found in 13.3% of P.anaerobius strains, clindamycin resistance was found in 34.8% of P.acnes and
13.3% of P.anaerobius strains. Additionnaly, one strain of P.granulosum was found resistant to clindamycin, one
strain of B.fragilis and one strain of P.melaninogenica were found resistant to penicillin and clindamycin.
Conclusions: Routine analyses of anaerobes in perforated corneal ulcers is inevitable and usage of appropriate
molecular methods, for the detection of bacteria responsible from severe infections which might not be deter-
mined by cultivation, may serve for the early decision of the appropriate treatment. Taking into account the in-
creasing antimicrobial resistance of anaerobic bacteria, alternative eye specific antibiotics effective against anaer-
obes are needed to achieve a successful treatment.
(Clin. Lab. 2014;60:1879-1886. DOI: 10.7754/Clin.Lab.2014.131113)
Correspondence:
Assos. Prof. Dr. Hrisi Bahar Tokman
Istanbul University
Cerrahpasa School of Medicine
Department of Medical Microbiology
34098, Istanbul, Turkey
Tel.: +90 212 414 30 00/23046
Fax: +90 212 5861547
Email: hrisibahar@gmail.com
_____________________________________________
Manuscript accepted May 18, 2014