Bacterial Keratitis: Isolated Organisms and Antibiotic Resistance Patterns in San Francisco

Peng, Ming-Yieh; Cevallos, Vicky; McLeod, Stephen D.; Lietman, Thomas M.; Rose‐Nussbaumer, Jennifer

doi:10.1097/ico.0000000000001417

Cited by 82 publications

(69 citation statements)

References 24 publications

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“…Tam et al reported that the proportion of gram-negative bacterial keratitis increased from 19% in 2000–2003 to 30% in 2012–2015 [ 12 ]. Pseudomonas species has continued to be the most common isolate of gram-negative bacterial keratitis; the proportion varies among countries, ranging from 10% of cases in North America [ 12 – 14 ], 24.4% in Taiwan [ 15 ], 32.5% in South Korea [ 16 ], and up to 52% in South India [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

Comparison of clinical characteristics and antibiotic susceptibility between Pseudomonas aeruginosa and P. putida keratitis at a tertiary referral center: a retrospective study

Cho

Lee

2018

BMC Ophthalmol

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BackgroundTo compare clinical characteristics and antibiotic susceptibilities in patients with Pseudomonas aeruginosa (PA) and P. putida (PP) keratitis at a tertiary referral center in South Korea.MethodsForty-nine cases of inpatients with culture-proven PA and PP keratitis were reviewed retrospectively between January 1998 and December 2017. We excluded cases of polymicrobial infection. Epidemiology, predisposing factors, clinical characteristics, antibiotic susceptibilities, and treatment outcomes were compared between the PA and PP groups. The risk factors for poor clinical outcome were evaluated on the basis of the total cohort and analyzed using multivariate logistic regression.ResultsA total of 33 eyes with PA keratitis and 16 eyes with PP keratitis were included. The mean age was 47.0 years in the PA group and 59.3 years in the PP group (p = 0.060). Differences were observed between the PA and PP groups in hypopyon (45.5% vs 6.3%, p = 0.006) and symptom duration (4.3 vs 9.5 days, p = 0.022). The most common predisposing factor for PA was wearing contact lenses (36.4%) and that for PP was corneal trauma (62.5%). No significant differences were observed in sex, previous topical steroid use, systemic disease, or duration of hospitalization between the two groups. The PA and PP groups both demonstrated good efficacy of colistin (both 100%), tobramycin (93.3%, 100%), ceftazidime (93.9%, 87.5%), and ciprofloxacin (96.6%, 87.5%). Imipenem (100% vs 81.3%, p = 0.030), piperacillin (96.6% vs 75%, p = 0.047), and ticarcillin (85% vs 0%, p < 0.001) showed significantly lower efficacy in the PP group than in the PA group. A poor clinical outcome was observed in 31.2% of the PA group and 37.5% of the PP group (p = 0.665). The risk factors for poor clinical outcome were previous ocular surface disease (odds ratio 10.79, p = 0.012) and hypopyon (odds ratio 9.02, p = 0.024).ConclusionsThe PA group was more closely associated with younger age, wearing contact lenses, shorter symptom duration, and hypopyon, whereas the PP group was more closely associated with elderly age, corneal trauma, and decreased efficacy of the beta-lactams. Clinical outcomes were not significantly different between the two groups. Previous ocular surface disease and hypopyon were the risk factors for poor clinical outcome.

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Section: Discussionmentioning

confidence: 99%

Comparison of clinical characteristics and antibiotic susceptibility between Pseudomonas aeruginosa and P. putida keratitis at a tertiary referral center: a retrospective study

Cho

Lee

2018

BMC Ophthalmol

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“…Similar microbiological profile has been reported in studies from other geographical regions in India[4] and the west. [5]…”

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confidence: 99%

Bacterial isolates in microbial keratitis: Three-year trend analysis from North India

Acharya

Farooqui

Singh

et al. 2019

Indian J Ophthalmol

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“…Currently, the likely causative microorganism is only isolated in 30% to 60% of cases using traditional scraping methods and standard conventional diagnostic culture (CDC), with results typically taking up to 3 days to become available to the clinician. 1 – 3 This may explain the reluctance of some ophthalmologists to perform a corneal scrape to reach a microbiological diagnosis. For example, McDonnell et al found that 49% of ophthalmologists treated corneal ulcers empirically without attempting to identify the causative organism.…”

Section: Introductionmentioning

confidence: 99%

16S Ribosomal RNA PCR Versus Conventional Diagnostic Culture in the Investigation of Suspected Bacterial Keratitis

Somerville

Corless²,

Sueke

et al. 2020

Trans. Vis. Sci. Tech.

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The purpose of this study was to compare conventional diagnostic culture (CDC) to 16S ribosomal RNA polymerase chain reaction (PCR) analysis for diagnosing bacterial keratitis. Methods: Samples collected from 100 consecutive patients presenting to the Royal Liverpool University Hospital with bacterial keratitis were processed using CDC and 16S PCR analysis. Results: The overall detection rate using both methods was 36%. Of these, 72.2% (26/36) were detected by PCR and 63.9% (23/36) isolated by CDC (P = 0.62). Using a combination of both PCR and CDC increased the detection rate for pathogenic bacteria by 13% compared to using CDC alone (P = 0.04). In CDC negative samples, 16S PCR identified more pathogens than CDC in 16S PCR negative samples. Neither order of sample collection nor prior antimicrobial use affected the detection rate. Conclusions: 16S rRNA gene PCR performed in addition to CDC on corneal samples from patients with clinically suspected bacterial keratitis led to additional pathogen detection. Translational Relevance: 16S rRNA gene PCR should be developed to become an additional part of clinical service for patients with bacterial keratitis rather than used in isolation.

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Bacterial Keratitis: Isolated Organisms and Antibiotic Resistance Patterns in San Francisco

Abstract: Gram-positive organisms are the most commonly identified etiology of microbial keratitis in this series. Approximately 35% of cultured organisms had variable susceptibility to moxifloxacin, and resistance seems to be increasing over time. The risk of culturing MRSA increased over time.

Cited by 82 publications

References 24 publications

Comparison of clinical characteristics and antibiotic susceptibility between Pseudomonas aeruginosa and P. putida keratitis at a tertiary referral center: a retrospective study

Comparison of clinical characteristics and antibiotic susceptibility between Pseudomonas aeruginosa and P. putida keratitis at a tertiary referral center: a retrospective study

Bacterial isolates in microbial keratitis: Three-year trend analysis from North India

16S Ribosomal RNA PCR Versus Conventional Diagnostic Culture in the Investigation of Suspected Bacterial Keratitis

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