{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T16:01:21Z","timestamp":1793721681710,"version":"4.6.1"},"reference-count":35,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Ocular Pharmacology and Therapeutics"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>This study investigated the bacterial and fungal contamination of preservative-free, multidose cyclosporine (PFMD-Cyc) bottles.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      One hundred PFMD-Cyc eye drops administered by different patients for a minimum of 3 weeks were analyzed. The caps and first and second drops from the bottles underwent microbiological testing using sheep blood agar, chocolate agar, Sabouraud dextrose agar, and\n                      <jats:italic toggle=\"yes\">Brucella<\/jats:italic>\n                      broth media. Conjunctival cultures were obtained from patients whose bottles were contaminated. The residual drug inside the contaminated bottles was examined by drilling the bottles\u2019 underside.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Microbial contamination was detected in 47% (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 47) of the samples, with both poly- and monomicrobial growth. Fifty-nine species (25 gram-positive and 11 gram-negative bacteria, 15 yeasts, and 8 molds) were identified in the contaminated bottles. The most prevalent microorganisms were\n                      <jats:italic toggle=\"yes\">Staphylococcus epidermidis<\/jats:italic>\n                      (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 11),\n                      <jats:italic toggle=\"yes\">Candida parapsilosis<\/jats:italic>\n                      (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 7), and\n                      <jats:italic toggle=\"yes\">Fusarium<\/jats:italic>\n                      spp. (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 4). Conjunctival cultures from 4 patients revealed the same pathogens identified in the contaminated bottle, including\n                      <jats:italic toggle=\"yes\">Serratia marcescens, Klebsiella aerogenes, Staphylococcus aureus,<\/jats:italic>\n                      and\n                      <jats:italic toggle=\"yes\">Candida parapsilosis<\/jats:italic>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>In addition to bacteria, a particularly high level of fungal contamination was detected. Conjunctival microorganisms were also detected in select samples. Patients should be advised to practice proper hand hygiene before administering eye drops. Moreover, meticulous attention to the storage conditions of medications during treatment is essential. Furthermore, research into fungal contamination of ophthalmical solutions, particularly immunosuppressive eye drops, is warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10807683251363844","type":"journal-article","created":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T16:53:50Z","timestamp":1759856030000},"page":"455-462","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Assessment of Bacterial and Fungal Contamination in Preservative-Free Multi-Dose Cyclosporine Eye Drops"],"prefix":"10.1177","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8156-6633","authenticated-orcid":false,"given":"Abdurrahman","family":"Sarmis","sequence":"first","affiliation":[{"name":"Department of Microbiology Laboratory, Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Istanbul, Turkiye."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5571-3735","authenticated-orcid":false,"given":"Omer Faruk","family":"Yilmaz","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Istanbul, Turkiye."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammed Ali","family":"Mutlu","sequence":"additional","affiliation":[{"name":"Department of Microbiology Laboratory, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkiye."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serap","family":"Karaca","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Istanbul, Turkiye."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deniz","family":"Turan","sequence":"additional","affiliation":[{"name":"Department of Microbiology Laboratory, Haydarpa\u015fa Numune Education and Research Hospital, Istanbul, Turkiye."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Halit","family":"Oguz","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Istanbul Medeniyet University Faculty of Medicine, Istanbul, Turkiye."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,10,14]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0271267"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtos.2017.05.003"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clae.2023.102064"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1080\/09273948.2019.1587470"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.3341\/kjo.2018.0116"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1089\/jop.2014.0030"},{"key":"e_1_3_4_8_2","volume-title":"StatPearls","author":"Castano G","year":"2025","unstructured":"Castano G, , Elnahry AG, , Mada PK. 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