ORIGINAL ARTICLES

Conjunctival fungal flora in a tertiary eye hospital in Nigeria

Benjamin U Adukwu¹, Sebastian N N Nwosu², Felix E Emele³, Chizoba Uba-Obiano², Adaora A Onyiaorah²

¹Guinness Eye CentreOnitsha, Nigeria
²Guinness Eye CentreOnitsha, Nigeria; Department of Ophthalmology, Nnamdi Azikiwe University, Nnewi Campus, Nnewi, Nigeria
³Department of Medical Microbiology, Nnamdi Azikiwe University, Nnewi Campus, Nnewi, Nigeria

Correspondence Address:
Prof. Sebastian N N Nwosu
Guinness Eye Centre, PMB 1534 Onitsha Nigeria

Source of Support: None
Conflict of Interest: None

Objectives: The aim of this study is to determine the hospital incidence and pattern of conjunctival fungal flora in adult patients at the Guinness Eye Center Onitsha, Nigeria.

Materials and Methods: New adult patients, without anterior segment disease, were randomly recruited. Using a sterile swab stick, specimen was taken from the inferior conjunctival fornix of each participant’s right eye and inoculated into Sabouraud dextrose agar slant in a test tube and incubated at 27°C. The specimens were examined for fungal growth every 48 h for 4 weeks. Specimens with fungal growth were further examined under a high power microscope for fungal identification and characterization.

Results: A total of 225 patients (105 males, 120 females) were examined. The age range was 18–75 years; mean age was 41 ± 17.1 years; 62 (27.6%) were culture-positive: 25 (40.3%) were males and 37 (59.7%) were females (P >0.05). Both moulds and yeasts were isolated with moulds constituting 44 (74.2%). Aspergillus [26 (41.9%)] and Candida [16 (25.8%)] were the commonest organisms. Participants >60 years had the greatest burden. Pensioners (61.5%), traders (44.0%), farmers (30.1%), and artisans (27.3%) were occupational groups with significantly higher proportions of culture-positive specimens (P < 0.05).

Conclusion: Over a quarter of new adult patients without anterior segment disease harbour fungi, some of which are pathogenic, in their conjunctival fungal organisms. While Aspergillus and Candida were the commonest isolates, older participants, pensioners, traders, farmers, and artisans had significantly higher proportion of culture-positive specimens. These findings should be considered when formulating pre-operative guidelines for ocular surgery in our environment.