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This study systematically analyzed real-world data (RWD) of patients to reveal the association between clinical factors and conjunctival sac bacterial load and offer prophylaxis suggestions.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We retrieved RWD of patients using levofloxacin eye drops (5\u00a0mL: 24.4\u00a0mg, 4 times a day for 3\u00a0days) preoperatively. Retrieved data included information on the conjunctival sac bacterial culture, sex, presence of hypertension and diabetes mellitus (DM), and history of hospital-based surgeries. Data was analyzed using SPSS 24.0.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>RWD of 15,415 cases (patients) were retrieved. Among these patients, 5,866 (38.1%) were males and 9,549 (61.9%) females. 5,960 (38.7%) patients had a history of hypertension, and 3,493 (22.7%) patients had a history of DM. 7,555 (49.0%) patients had a history of hospital-based operations. There were 274 (1.8%) positive bacterial cultures. Male patients with hypertension and DM may be at increased risk of having positive bacterial cultures (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05). <jats:italic>Staphylococcus epidermidis<\/jats:italic> (<jats:italic>n<\/jats:italic>\u2009=\u200956, 20.4%), <jats:italic>Kocuria rosea<\/jats:italic> (<jats:italic>n<\/jats:italic>\u2009=\u200937, 13.5%), and <jats:italic>Micrococcus luteus<\/jats:italic> (<jats:italic>n<\/jats:italic>\u2009=\u200932, 11.7%) were the top 3 isolated strains. Most bacterial strains were resistant to various antibiotics except rifampin, and 82.5% (33 of 40 isolates) of <jats:italic>Staphylococcus epidermidis<\/jats:italic> isolates had multidrug antibiotic resistance. Numbers of culture-positive <jats:italic>Staphylococcus epidermidis<\/jats:italic> isolates in the male group and non-DM group were greater than those in the female and DM groups, respectively. <jats:italic>Micrococcus luteus<\/jats:italic> (<jats:italic>n<\/jats:italic>\u2009=\u200911, 8.8%) was found less frequently in non-hypertension group than in hypertension group.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Sex (Male) and the presence of hypertension and DM are risk factors for greater conjunctival sac bacterial loads. We offer a prophylactic suggestion based on the combined use of levofloxacin and rifampin. However, this approach may aggravate risk of multidrug resistance.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12886-022-02544-2","type":"journal-article","created":{"date-parts":[[2022,7,30]],"date-time":"2022-07-30T08:06:51Z","timestamp":1659168411000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Conjunctival sac bacterial culture of patients using levofloxacin eye drops before cataract surgery: a real-world, retrospective study"],"prefix":"10.1186","volume":"22","author":[{"given":"Zhenyu","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pei","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chen","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yining","family":"Guo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuhe","family":"Dong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7822-4694","authenticated-orcid":false,"given":"Xuemin","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,7,30]]},"reference":[{"issue":"1","key":"2544_CR1","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1186\/s12886-017-0413-7","volume":"17","author":"T Kawata","year":"2017","unstructured":"Kawata T, Matsuo T. 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The Medical Ethics Committee of Peking University Third Hospital (Beijing, China) approved all procedures of the present study, including the procedure of accessing the clinical\/personal patient data used in our research (approval number: M2019432).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no conflict of interest.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"328"}}