A case of suture-related bacterial keratitis and its treatment with topical imipenem

Türkyılmaz, Kemal; Kurt, Ali; Dilek, Aziz Ramazan; Şekeryapan, Berrak; Ertürk, Ayşe

doi:10.1007/s12177-012-9081-2

Cited by 3 publications

(3 citation statements)

References 13 publications

(18 reference statements)

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“…The keratitis infection caused by P. aeruginosa usually form corneal biofilms [ 52 ]. In a case of the treatment of bacterial keratitis in patients, topical imipenem (50 mg/mL) has been selected as monotherapy for corneal infection [ 53 ]. In another study, 1–5 mg/mL imipenem has been used for bacterial keratitis treatment via topical administration [ 54 ].…”

Section: Discussionmentioning

confidence: 99%

rpoS-mutation variants are selected in Pseudomonas aeruginosa biofilms under imipenem pressure

et al. 2021

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Background Pseudomonas aeruginosa is a notorious opportunistic pathogen causing various types of biofilm-related infections. Biofilm formation is a unique microbial strategy that allows P. aeruginosa to survive adverse conditions such as antibiotic treatment and human immune clearance. Results In this study, we experimentally evolved P. aeruginosa PAO1 biofilms for cyclic treatment in the presence of high dose of imipenem, and enriched hyperbiofilm mutants within six cycles in two independent lineages. The competition assay showed that the evolved hyperbiofilm mutants can outcompete the ancestral strain within biofilms but not in planktonic cultures. Whole-genome sequencing analysis revealed the hyperbiofilm phenotype is caused by point mutations in rpoS gene in all independently evolved mutants and the same mutation was found in P. aeruginosa clinical isolates. We further showed that mutation in rpoS gene increased the intracellular c-di-GMP level by turning on the expression of the diguanylate cyclases. Mutation in rpoS increased pyocyanin production and virulence in hyperbiofilm variants. Conclusion Here, our study revealed that antibiotic treatment of biofilm-related P. aeruginosa infections might induce a hyperbiofilm phenotype via rpoS mutation, which might partially explain antimicrobial treatment failure of many P. aeruginosa biofilm-related infections.

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Section: Discussionmentioning

confidence: 99%

rpoS-mutation variants are selected in Pseudomonas aeruginosa biofilms under imipenem pressure

et al. 2021

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“…Topical use of both imipenem and linezolid has been reported in few cases of corneal infections [14][15][16][17][18][19][20][21]. Furthermore, Elsahn et al reported that 21 isolates of Staphylococcus aureus and 29 of methicillin-resistant coagulasenegative Staphylococcus recovered from infectious keratitis cases showed 100% in vitro susceptibility for linezolid [22].…”

Section: Discussionmentioning

confidence: 99%

Minimum inhibitory concentrations and resistance for selected antimicrobial agents (including imipenem, linezolid and tigecycline) of bacteria obtained from eye infections

Galvis

Tello

Sánchez

et al. 2020

rjo

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Objective: To determine bacteria obtained from eye infections, both resistance and minimal inhibitory concentration (MIC) to gatifloxacin, moxifloxacin, tigecycline, linezolid and imipenem, in vitro. Methods: A cross-sectional descriptive study was undergone with 50 samples from 50 eyes of patients diagnosed with keratitis or endophthalmitis, who came to a consultation at the Fundación Oftalmológica de Santander (Floridablanca, Colombia) from August to November 2014. The MICs of the isolated microorganisms were established through Etest® strips (BioMérieux SA, Marcy-l'Etoile -France). Results: Of the 50 samples in total, 17 different bacteria species or groups were isolated. The main isolate for gram-positives was Methicillin Resistant Coagulase-Negative Staphylococcus (17 samples), and for gram-negatives was Pseudomonas aeruginosa (6 samples). The susceptibility percentages sorted from highest to lowest for gram-positive isolates (n=38) were: imipenem 90.3%, linezolid 87.9%, tigecycline 78.1%, gatifloxacin 68.8% and moxifloxacin 68.8%. For gram-negative isolates (n=12), they were: imipenem 72.7%, gatifloxacin 70%, moxifloxacin 66.7% (no reference cut-off points were found for Pseudomonas aeruginosa), tigecycline 22.2%, and linezolid 0% (as expected according to its inhibition spectrum). Conclusions: Although fourth generation fluoroquinolones are currently the preferred initial empirical monotherapy in our practice, given the increasing bacterial resistance, in cases in which gram-positive bacteria were isolated in the initial staining imipenem, linezolid or tigecycline could be used as an alternative. On the other hand, for cases of gram-negative bacteria, no antimicrobial susceptibility exceeded 80%, so using two antimicrobials looking for a synergy between them could be a better option.

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“…45 In addition to being the other antibiotic (besides colistin) for which high susceptibility has been reported in MDR-PA, [41][42][43][46][47][48] imipenem is also effective in atypical keratitis (nocardia 32,49 nontuberculosis mycobacteria 29,50,51 ) and it has also been a preferred antibiotic in resistant and polymicrobial keratitis due to its broad spectrum of suitability for empirical monotherapy. 52 Jain et al 53 treated eight patients with MDR-PA with ciprofloxacin and 5% cefazolin in the first 48 hrs, before antibiotic susceptibility test results were reported, then with topical colistin 0.19%. They reported recovery with scarring in four cases, medical recovery requiring cyanoacrylate supplementation in three cases, and recourse to sclerocorneal patch surgery in one case.…”

Section: Antibiotics In Multidrug Resistancementioning

confidence: 99%

<p>Treatment-Resistant Bacterial Keratitis: Challenges and Solutions</p>

Eğrilmez¹,

Yildirim-Theveny²

2020

OPTH

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Bacterial keratitis is an important ophthalmic emergency and one of the most common causes of corneal blindness. The main causes of treatment resistance in bacterial keratitis are failure to eliminate predisposing factors, misdiagnosis and mistreatment. At first, exogenous, local and systemic predisposing factors that disturbing ocular surface must be eliminated to improve corneal ulcers and to prevent recurrences. Smears and scrapings for staining and culture are indispensable diagnostic tools for cases of sight-threatening keratitis (centrally located, multifocal, characterized by melting, painful). Main treatment agents in bacterial keratitis treatment are topical antibiotics. Until the results of culture antibiograms reach the ophthalmologist, empirical antibiotic selections based on direct microscopic examination and gram stain findings are the most appropriate initial treatment approach currently. S. aureus and coagulase-negative staphylococci (CoNS), the most common gram-positive agents, have resistance rates of more than 30% for fluoroquinolone and methicillin. Multidrug resistance rates are similarly high in these microorganisms. P. aeruginosa is the most common gram-negative micro-organism, in case of multidrug-resistant isolates, both functional and anatomical prognosis of the eyes are very poor. In cases of sight-threatening and resistant keratitis, antibiotic susceptibility testing containing imipenem, colistin, and linezolid is seeming to be an important requirement. Despite its efficiency limited to superficial cases, a nonpharmaceutical anti-infective treatment option such as corneal crosslinking for bacterial keratitis is an emerging hope, while antibiotic resistance increases.

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A case of suture-related bacterial keratitis and its treatment with topical imipenem

Cited by 3 publications

References 13 publications

rpoS-mutation variants are selected in Pseudomonas aeruginosa biofilms under imipenem pressure

rpoS-mutation variants are selected in Pseudomonas aeruginosa biofilms under imipenem pressure

Minimum inhibitory concentrations and resistance for selected antimicrobial agents (including imipenem, linezolid and tigecycline) of bacteria obtained from eye infections

<p>Treatment-Resistant Bacterial Keratitis: Challenges and Solutions</p>

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