Unorthodox ophthalmic preparations on the Ghanaian market: a potential risk for ocular and enteric infections

PURPOSE: Microbial contamination of orthodox ophthalmic preparations poses a serious threat to the user by causing ocular infections. There is no such information about unorthodox ophthalmic preparations in a medical pluralistic system such as Ghana. The aim of this study was to assess unorthodox ophthalmic medications on the Ghanaian market for possible microbial contaminations. METHODS: Unorthodox ophthalmic preparations were collected across different herbal and homeopathic outlets in Ghana. A total of 27 samples were collected from the ten (10) regions in Ghana. The samples were inoculated in different culture media (Plate count Agar, Blood Agar, MacConkey Agar, Saboraud Dextrose Agar). The microorganisms isolated were identified using standard microbiological procedures and antimicrobial susceptibility was done to determine whether they were resistant or susceptible strains. RESULTS: All the samples were contaminated with bacteria and the majority were contaminated with fungus. A total of forty-eight bacteria spp. was isolated thus seven different types namely: Staphylococcus aureus, Bacilli spp., Serrati spp., Escherichia coli, Pseudomonas spp., Klebsiella spp. and Shigella spp. with Staphylococcus aureus being the predominant bacteria. For fungi, a total of eleven fungi species thus four different types namely: Cephalosporium spp., Penicillium spp., Cercosporium spp. and Clasdosporium spp. with the predominant fungi being Penicillium spp. Per the class of preparations, 15 contaminants were isolated from ten (10) anti-inflammatory preparations. The fungi were all susceptible to both Ketoconazole and Fluconazole but the bacteria were resistant to all the conventional antibiotics except Ciprofloxacin and Gentamycin. CONCLUSION: Unorthodox ophthalmic preparations found on the Ghanaian market are contaminated with bacteria and fungi of clinical importance.