Introduction

The conjunctiva is a mucous membrane which covers the under surface of the lids and is reflected from the lids to cover part of the eye ball up to the margin of the cornea. (jain ,1990 ) .

In spite of natural protective mechanism of the conjunctiva in the from of low temperature due to the exposure to the air, presence of enzymes in the tears called lysozyme (which have definite anti-bacterial property) and the mechanical action of blinking and flushing action of the lacirmal secretion, the conjunctival sac my be infected with pathogenic organisms causing infective conjunctivitis. ( soy , 1995 )

The choice of an antimicrobial is not only influenced by the type and susceptibility of the infecting organism, but also by the mode of action and the pharmacokinetics of the antibiotics, the severity and localization of the infections, the liver and kidney functions as well as the age of the patient. When more than one antibiotic is used, a part from the spectrum of the individual antibiotic, synergism and antagonism must be kept in mind.( smith , etal 1997 ) .

Many advanced studies such as ( Aggarwal., etal. ,1992. , Fok , etal. , 1995 ., Harris , etal. , 1996 , Duch , etal ., 1997 ., and Zaidi , etal ., 1999 ) were interested in conjunctivitis and studied this disease and causative agents from various views .

Because there are no local study on conjunctivitis the aims of this study are determination the major bacterial types causing conjunctivitis and study of efficiency of some plant extracts from Zizyphus Spina christi and Olea europaea .

Material and methods

Sampling

Bacteriological study

Plant extracts

Antibiotics

Evaluation the antibacterial activity

Results and discussion

Our. results revealed a highly infected conjunctivitis (77.7%) with various species of aerobic and facultative anaerobic bacteria (87 isolates). Double mode of isolated bacterial types are predominant in 34.6 % from the cases followed by other modes .

Other studies revealed that any organisms which affects the mucous membrane any where in the body, can also invade the conjunctiva. According to the frequency the common organisms which affect the conjunctiva and cause a conjunctivitis are coagulate positive staphylococci, bacilli which are ting gram negative bacilli. Adenomas can also cause conjunctivitis sometimes in epidemic form (Fok., etal ., 1995 ., Pitaksiripan ,etal ., 1995 ., Fleiszing ., etal., 1996 )

The pathologic markers occur in conjunctivitis due to looseness of epithelium particularly of the bulbar conjunctiva and that of the for mix the exudate containing fibrin and leucocytes comes to the surface in the form of discharge. Also, the superficial cells, which form the second line of defense (first line being formed by the leucocytes) phagocytes are invading agents and are themselves desquamated. The basal layer of the cells proliferates and make up the deficiency .( Jain ,1990 )

The Staph.aureus in our study was found predominant in 53.06% of positive cases followed by other bacterial types. The ability of Staph.aureus to cause a disease may be due to production of large number of enzymes, toxins and other substances, some of which may play an important role in their capacity to cause conjunctivitis.

Other studies supported results of our study that the same bacteria were associated with conjunctivitis (Harris , etal ., 1996 , Duch ., etal ., 1997 ., Iroha , etal .,1998, Friedlaender ., 1998 . and Zaidi , etal ., 1999 )

Figure 1

Table 1: modes of infectious bacterial types isolated from 49 conjunctivitis patients

Figure 2

Table 2: bacterial types isolated from 49 positive cultured cases of patients with conjunctivitis.

Figure 3

Table 3: Antibacterial activity of extractes of Z

Figure 4

Table 4: Determination of minimal inhibitory concentrations (mics) of extractes of and against . isolated from patients with conjunctivitis.

Figure 5

Table 5: A comparison of antibacterial activity of standard antibiotics against isolated from conjunctivitis patients