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Article
January 1992

Microbial Contamination of In-Use Ocular Medications

Author Affiliations

From the Dana Center for Preventive Ophthalmology, The Wilmer Institute, The Johns Hopkins University, Baltimore, Md (Dr Schein); Massachusetts Eye and Ear Infirmary (Drs Hibberd, Starck, Baker, and Kenyon); and Department of Infectious Diseases, Massachusetts General Hospital (Drs Hibberd and Baker), Boston.

Arch Ophthalmol. 1992;110(1):82-85. doi:10.1001/archopht.1992.01080130084030
Abstract

• Two hundred twenty in-use medications from 101 patients with nonmicrobial ocular surface disease were studied by culturing the bottle caps, a drop produced by simple inversion, and the interior contents removed sterilely. Conjunctival cultures were taken from these patients and 50 age-matched controls. Pathogenic organisms were harvested from conjunctivae significantly more frequently (P<.01) from cases (34 of 101) than from controls (five of 50). Sixty-four medications (29%) had microorganisms cultured from at least one medication site. Gram-negative organisms were significantly more likely (P<.00001) to be isolated from all medication sites than gram-positive organisms. Additionally, when isolated from medication sites, the gram-negative organisms were highly likely to be cultured from the conjunctiva as well. This was not true for pathogenic gram-positive organisms. We conclude that a cycle of contamination between inuse medications and conjunctivae may represent an important risk factor for microbial keratitis in patients with ocular surface disease.

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