Purpose/Aim: This study aims to evaluate the predisposing risk factors and antibiotic resistance of bacterial corneal ulcer to commonly used antibiotics. In addition, assess the in vitro efficacy of plant-derived essential oils (EOs) as safe and effective antimicrobial agents.
Methods: Demographic features and predisposing risk factors of corneal ulcer patients were recorded. Isolation and identification of bacteria was performed using conventional microbiological methods. Antibacterial activity was determined by disk diffusion and the micro-dilution broth methods. EOs were extracted by steam distillation and were analyzed by gas chromatography mass spectrometry technique.
Results: Out of the 200 patients with corneal ulcer evaluated in this study, the main predisposing factor of bacterial corneal ulcer was trauma (26.5%) and 96.7% isolates were multidrug resistant. Staphylococcus aureus was the predominant isolate 33 cases. Antibiotic susceptibility of bacterial isolates showed that the fourth-generation fluoroquinolones, gatifloxacin was the most effective antibiotic with sensitivity rate 81.3%. Seven selected EOs showed significant activity against most of the tested bacteria. Syzygium aromaticum oil showed high activity against all tested bacterial species with highest sensitivity rate (97.5%) and low minimal inhibitory concentration values against S. aureus (0.10 µl/ml). The chemical composition of the EOs showed that the monoterpenes were predominant. The main constituent of S. aromaticum oil was eugenol (76%).
Conclusions: The current study showed that S. aromaticum oil had high antibacterial activity that could be helpful in the treatment of ocular bacterial infections to minimizing the possible side effects of commonly used antibiotic.
Keywords: Multidrug-resistant bacteria; Staphylococcus aureus; antimicrobial resistance; bacterial keratitis; predisposing factors.