Floral Differences of Conjunctiva in Patients with Renal Diseases

Abstract

Objectives: This study aimed to evaluate whether conjunctival flora is different in patients with chronic renal disease (CR) among its subgroups and healthy subjects. Methods: A total of 105 adult CR patients; 35 hemodialysis (HD), 35 diabetic hemodialysis (DHD), 35 renal transplantation (RT), and 40 healthy subjects were enrolled. After ophthalmologic examination, a swab was taken from the lower fornix of the right eye using a cotton-tipped applicator and directly sub-cultured on 5% sheep’s blood agar, chocolate agar, and eosin methylene blue agar. Differences in both bacterial growth and flora diversity of the groups were compared. Results: The order of bacterial growth rates in the groups are RT 65%), DHD (57%), HD (56%), and control (48%). The RT group had a statistically significant difference from the control group (p<0.05), but there is no difference among other groups. There is also no correlation between the duration of diabetes, hemodialysis, or transplantation with bacterial growth. The most frequently isolated bacteria are Staphylococcus hominis (23%) and Kocuria rosea (11%) in HD; Staphylococcus epidermidis (20 %) and S. hominis (15%) in DHD; K. rosea (17%) and S. hominis (14%) in RT and S. epidermidis (22%) and K. rosea (10%) in controls. Conclusion: The most prominently isolated bacteria in the RT group and overall were coagulase-negative staphylococcus species. Unlike previous reports, S aureus, a more pathogenic microorganism, was less isolated, but Kocuria species were detected as one of the most prevalent types in this study. The study suggests the condition of hemodialysis and diabetes have little effect on bacterial flora, and the RT group receiving immunosuppressive drugs significantly differed in both bacterial growth and flora diversity.

Keywords

• Ocular flora
• Chronic renal disease
• Ocular surface; Diabetes
• Renal Transplantation

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