The microbial contamination of commonly used multi-dose eye drops in glaucoma patients

doi:10.3877/cma.j.issn.2095-2007.2021.06.007

Abstract

Abstract:

Objective

The aim of this study was to investigate the microbial contamination and microbial species of ophthalmic multi-dose eye drops in glaucoma patients.

Methods

250 eye drops used by glaucoma patients in the Ophthalmology Clinic of the First Affiliated Hospital of Soochow University from May 2019 to April 2020 were collected. Among them, there were 212 anti-glaucoma eye drops, 9 antibiotic eye drops, 15 antibiotic steroid eye drops, 7 non-steroidal anti-inflammatory eye drops and 7 mydriasis eye drops. The dropper tip and the residual eye drops in the bottle were collected and cultured respectively, and then microbial species were identified. The type of eyedrop bottle, the number of contaminated cases and the number of positive contaminated bacteria were expressed as frequency. The composition of eye drop bottles and positive contaminating bacteria and the contamination rate of eye drops were expressed as the number of cases and percentage. Chi-square test or Fisher′s exact test were used for comparison between groups.

Results

16 of 250 eye drops were contaminated, accounting for 6.4%. 14 and 2 contaminated eye drops were detected in the dripper tip group and the residual eye drops group, accounting for 5.6% and 0.8%, respectively. Chi-square test showed that there was statistically significant difference between two groups (χ²=9.298, P<0.05). 14 and 2 contaminated eye drops were detected in anti-glaucoma eye drops group and non-anti-glaucoma eye drops group, accounting for 6.6% and 5.3%, respectively. Chi-square test showed that there was no significant difference between two groups (χ² = 3.619, P>0.05). None and 16 contaminated eye drops were detected in antibiotic eye drops group and non antibiotic eye drops group, accounting for 0 and 7.0%, respectively. Fisher′s exact test showed that there were statistically significant difference between two groups (P<0.05). The contaminated microorganisms were composed of 16 bacterial strains and 2 fungal strains. 3 strains of Staphylococcus epidermidis accounting for 16.7%, 3 strains of Escherichia coli accounting for 16.7%, and 2 strains of Corynebacterium accounting for 11.1%, were the top three of frequency contaminated microbial. The detection of contamination in the dropper tip group was higher than that in the bottle residual eye drops group, and that in the non-antibiotic eye drops group was higher than that in the antibiotic group.

Conclusions

The contaminated microorganisms were mainly Staphylococcus epidermidis, Escherichia coli and Corynebacterium. Multi-dose eye drops are susceptible to microbial contamination, should be paid attention to the drug safety of eye drops for glaucoma patients.

Key words: Glaucoma, Multi-dose, Eye drop, Microbial contamination

Yingming Wang, Xue Yin, Yalu Ren, Xiaofeng Zhang. The microbial contamination of commonly used multi-dose eye drops in glaucoma patients[J]. Chinese Journal of Ophthalmologic Medicine(Electronic Edition), 2021, 11(06): 359-364.

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Figures/Tables 6

References 43

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名称		生产厂家
抗青光眼
	硝酸毛果芸香碱滴眼液	山东博士伦福瑞达制药有限公司
	盐酸卡替洛尔滴眼液	中国大冢制药有限公司
	布林佐胺滴眼液	美国Alcon公司
	酒石酸溴莫尼定滴眼液	英国Allergan制药公司
	曲伏前列素滴眼液	美国Alcon公司
抗生素
	左氧氟沙星滴眼液	日本参天制药株式会社
抗生素类固醇
	妥布霉素地塞米松滴眼液	美国Alcon公司
	非甾体抗炎
	普拉洛芬滴眼液	日本Senju制药株式会社
散瞳
	复方托吡卡胺滴眼液	日本参天制药株式会社

名称		生产厂家
抗青光眼
	硝酸毛果芸香碱滴眼液	山东博士伦福瑞达制药有限公司
	盐酸卡替洛尔滴眼液	中国大冢制药有限公司
	布林佐胺滴眼液	美国Alcon公司
	酒石酸溴莫尼定滴眼液	英国Allergan制药公司
	曲伏前列素滴眼液	美国Alcon公司
抗生素
	左氧氟沙星滴眼液	日本参天制药株式会社
抗生素类固醇
	妥布霉素地塞米松滴眼液	美国Alcon公司
	非甾体抗炎
	普拉洛芬滴眼液	日本Senju制药株式会社
散瞳
	复方托吡卡胺滴眼液	日本参天制药株式会社

滴眼液名称	滴头		瓶内残留滴眼液
滴眼液名称	支数	占比(%)	支数	占比(%)
硝酸毛果芸香碱滴眼液	2	21.4	1	50.0
盐酸卡替洛尔滴眼液	3	28.6	1	50.0
布林佐胺滴眼液	2	14.3	0	0
酒石酸溴莫尼定滴眼液	2	14.3	0	0
曲伏前列素滴眼液	1	7.1	0	0
左氧氟沙星滴眼液	0	0	0	0
妥布霉素地塞米松滴眼液	0	0	0	0
普拉洛芬滴眼液	1	7.1	0	0
复方托吡卡胺滴眼液	1	7.1	0	0
总计	14	100.0	2	100.0

滴眼液名称	滴头		瓶内残留滴眼液
滴眼液名称	支数	占比(%)	支数	占比(%)
硝酸毛果芸香碱滴眼液	2	21.4	1	50.0
盐酸卡替洛尔滴眼液	3	28.6	1	50.0
布林佐胺滴眼液	2	14.3	0	0
酒石酸溴莫尼定滴眼液	2	14.3	0	0
曲伏前列素滴眼液	1	7.1	0	0
左氧氟沙星滴眼液	0	0	0	0
妥布霉素地塞米松滴眼液	0	0	0	0
普拉洛芬滴眼液	1	7.1	0	0
复方托吡卡胺滴眼液	1	7.1	0	0
总计	14	100.0	2	100.0

组别	支数	检测结果
组别	支数	阳性	阴性
滴头组	250	14(5.60)	236(94.40)
瓶内残留滴眼液组	250	2(0.80)	248(99.20)
χ²值		9.298
P值		<0.05

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