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Purpose:  To establish  in vitro and in vivo  ocular co-culture models of  Staphylococcus epidermidis  and  Enterococcus faecalis  and to study how various concentrations of moxifloxacin affect the survival of these two endophthalmitis-causing bacteria.   Methods:  Standard strains of  S. epidermidis  and  E. faecalis  were used. Color detection agar plates were employed to distinguish their colonies. To establish the  in vitro  and  in vivo  co-culture models,  S. epidermidis  and  E. faecalis  were co-cultivated at different ratios for various periods. For the  in vivo  model, various volumes and concentrations of either a mono-culture or co-culture were inoculated into the lower conjunctival sac of rabbits. Finally, the newly developed  in vitro  and  in vivo  co-culture models were subjected to the moxifloxacin treatment to access its effect on  S. epidermidis  and  E. faecalis .   Results:  When  S. epidermidis  and  E. faecalis  were cultured separately in tryptic soy broth, their growth peaked and plateaued at approximately 16 and 6 h, respectively. When they were co-cultured, the growth peak of  S. epidermidis  got delayed, whereas the growth peak of  E. faecalis  did not change. The number of  E. faecalis  was significantly higher in the co-culture than that in the mono-culture. Treatment with moxifloxacin in the  in vitro  co-culture model rapidly decreased the number of  S. epidermidis  cells at doses ≥ 0.125 μg/ml. In contrast, the number of  E. faecalis  did not change significantly up to 16 μg/ml moxifloxacin. In  in vivo  co-culture (at 1:1), the  S. epidermidis  count decreased in a pattern similar to that seen in  in vivo  mono-culture and was barely detectable at 24 h after inoculation. In contrast, the of  E. faecalis  count increased up to 16 h and then decreased. When moxifloxacin was applied (zero, one, or two times) to this model, the  S. epidermidis  count decreased in proportion to the number of treatments. In contrast, the  E. faecalis  count increased with moxifloxacin treatment.   Conclusions:  The  in vitro  and  in vivo  co-culture models of  S. epidermidis  and  E. faecalis  were established to determine the influence of moxifloxacin eye drops on these bacteria. The results clearly show that the moxifloxacin eye drops can make  E. faecalis  dominant on the ocular surface.

frontiers in medicine

Establishing in vitro and in vivo Co-culture Models of Staphylococcus epidermidis and Enterococcus faecalis to Evaluate the Effect of Topical Fluoroquinolone on Ocular Microbes