Background: The normal flora of the eye plays an important role in maintaining ocular homeostasis by various mechanisms. They comprise mainly bacteria which do not cause infection in normal conditions but can be a main source of infection after ocular surgery, trauma or in immunocompromised patients. Immune function is compromised in diabetes mellitus. Patients with diabetes mellitus (DM) are prone to infection because glucose in the skin, urine, mucous membranes and tears promotes growth of microorganism.
Aim of the Work: To detect the presence of pathogenic bacteria other than floral bacteria which are important pathogens of ocular infections in diabetic patients.
Patients and Methods: This cross-sectional descriptive study was carried out on sixty eyes of sixty patients attending ophthalmology outpatients clinic at Ain Shams University Hospitals. The study was conducted in accordance with the ethical standards stated in the Faculty of Medicine with informed consent obtained.
Results: Among 60patients, 26 were males and 34 were females, 35 had NPDR (58%), 25 had PDR (44%), 24 on OHG (40%) ,36 on insulin (60%). Growth of some bacteria was seen in 29 patients (48.3%) out of 60 eyes. The commonest flora isolated was staph coagulase negative (Staph CONg) 31.7%, next was candida 16,7%. Mixed infections had been found in many patients, 57.77% of male subjects had sterile conjunctiva compared to 47.1% in the females. The swab culture of rest of the subjects showed that Staph CONg were the predominant normal flora in both 30.8% and 32.4% in males and females respectively. However, Candida species were found significantly higher in females 23.5%. Positive conjunctival culture was found higher in patients on insulin than OHG, although staph cong, non-hemolytic streptococcus &candida were found higher in patients on insulin therapy but there had no statistical significance, candida was found higher in stage of NPDR than PDR and had statistical significance.
Conclusion: Gram-positive bacteria and candida were detected in higher ratios in the conjunctival flora of diabetic patients. Considering that flora elements may be important pathogens in ocular infections, treatment approaches to gram-positive bacterial and fungal infections should not be ignored in cases of ocular infections in diabetics.