A new method to predict the epidemiology of fungal keratitis by monitoring the sales distribution of antifungal eye drops in Brazil.

PURPOSE: Fungi are a major cause of keratitis, although few medications are licensed for their treatment. The aim of this study is to observe the variation in commercialisation of antifungal eye drops, and to predict the seasonal distribution of fungal keratitis in Brazil. METHODS: Data from a retrospective study of antifungal eye drops sales from the only pharmaceutical ophthalmologic laboratory, authorized to dispense them in Brazil (Opthalmos) were gathered. These data were correlated with geographic and seasonal distribution of fungal keratitis in Brazil between July 2002 and June 2008. RESULTS: A total of 26,087 antifungal eye drop units were sold, with a mean of 2.3 per patient. There was significant variation in antifungal sales during the year (p<0.01). A linear regression model displayed a significant association between reduced relative humidity and antifungal drug sales (R2 = 0.17,p<0.01). CONCLUSIONS: Antifungal eye drops sales suggest that there is a seasonal distribution of fungal keratitis. A possible interpretation is that the third quarter of the year (a period when the climate is drier), when agricultural activity is more intense in Brazil, suggests a correlation with a higher incidence of fungal keratitis. A similar model could be applied to other diseases, that are managed with unique, or few, and monitorable medications to predict epidemiological aspects.

Contaminaçäo de frascos de colírios de soro autólogo / Eyedroppe bottles contamination of autologous serum

Objetivo: A valiar a contaminaçäo bacteriana dos frascos de soro autólogo após o uso tópico. Métodos: Frascos de soro autólogo utilizados por pacientes portadores de várias doenças de superfície ocular foram submetidos à cultura após o seu uso tópico. Foram cultivados os resíduos de 127 frascos de colírios de soro autólogo usados por pacientes após a devoluçäo do frasco vazio ao laboratório. Resultados: Os resultados das culturas realizadas demonstram que 76,03 por cento dos frascos estavam contaminados. O total de 92 microrganismos foram encontrados: Staphylococcus coagulase-negativo (35,86 por cento),Alcaligenessp (21,73 por cento), Klebsiella sp (20,65 por cento) e Bacillus sp (9,78 por cento) e outras bactérias (11,94 por cento). Conclusöes: Verificamos que a contaminaçäo dos frascos pode ocorrer tanto por microrganismos presentes na microbiota normal quanto por microrganismos da pele e meio ambiente. Estes resultados ressaltam a risco de contaminaçäo dos frascos no momento da instilaçäo. Futuras investigaçöes seräo feitas em busca de contaminaçäo fúngica e relacionando a microbiota dos pacientes com os microrganismos isolados dos frascos.