Sir,

We thank Dr Nestel1 for his interest in our study.2 We found some associations between the pathogenic conjunctival bacteria and the systemic co-morbidities of patients undergoing cataract surgery, which was the main purpose of the study. Among these associations, we found that enterococci prevalence is associated with age and diabetes. Owing to the current wide use of intracameral cefuroxime for the cataract surgery prophylaxis,3, 4 we introduced the example of the postoperative endophthalmitis (PE) caused by enterococci for illustrating the implications of our findings in the management of patients carrying conjunctival bacteria resistant to a particular prophylaxis, such as the enterococci to cefuroxime, as Dr Nestel pointed. The systemic co-morbidities associations with other bacteria (for instance multi-resistant Staphylococcus) could also help in choosing a prophylaxis.

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