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

Abstract

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.

Voriconazole in Treatment of Resistant Fungal Keratitis

“…Higher incidence of fungal keratitis in male patients may be due to our social set up where males are more exposed to outdoors than women and it was comparable with other studies done by Al-Hatim et al and CH Cho et al 14,15 Ideally every corneal scraping should be sent for PCR and culture for diagnosis. PCR takes only two to three hours and culture takes up to 35 days.…”

Clinical Characteristics of External Ocular and Periocular Infections and Their Antimicrobial Treatment Patterns Among a Ghanaian Ophthalmic Population; A Multicenter Study

“…Furthermore, in a prospective observational study among patients undergoing cataract surgery in the USA, Ta et al showed that almost eight of every ten ocular specimen obtained from patients eyes had a bacteria etiology 26 . On the one hand, estimates from the present study is signi cantly higher and varies substantially compared to studies in China 13,18 , Iran 20 , South Korea 14 and Nepal 15 with prevalence estimates far lower than 50% [13][14][15]18,20 . Although geographical settings, study population, seasonality and laboratory procedures could account for such variations as reported earlier, a plausible reason for our observation may be attributable to the fact that our study unlike previous investigations enrolled patients from multiple eye care facilities hence the burden of infections maybe summative.…”

“…Though microscopic, the wide biodiversity of bacteria pathogens makes it burdensome for ophthalmic clinicians and physicians when selecting appropriate antibiotic therapy in routine clinical management of ocular and periocular infections. Previously, authors from several geographical jurisdictions have investigated the burden and etiology of bacteria eye infections, however, outcomes from these studies varied considerably [13][14][15]18,20,25,26 . The prevalence estimates of medical conditions such as bacteria ocular and periocular infections are critical in informing eye care service delivery and in the development of policies to strengthen eye care practices yet there is presently limited ophthalmic data to propagate such transitions within the Ghanaian context.…”

“…Globally, eye infections of bacteria origin remain a signi cant contributor to ocular morbidity and blindness, and the burden is increasing 1,2 . Further, results from ocular microbial studies across different populations show no obvious pattern in prevalence estimates (ranging from 21.8-82.5%) across Africa [2][3][4][5][6][7][8][9][10][11][12] , Asia [13][14][15][16][17][18][19][20] , Australia 21,22 , Europe [23][24][25] and North America 26 . Similarly, the bacterial etiology speci cally proportion and nature of Gram bacteria as well as the species of bacteria commonly implicated in ocular and periocular infections vary across geographical regions and settings 2-13,15−20,22,24−26 .…”

Efficacy of Voriconazole Corneal Intrastromal Injection for the Treatment of Fungal Keratitis

“…The duration of symptoms was defined as the interval between the onset of symptoms and the initial visit. The corneal ulcers were classified into central or peripheral lesions based on the half radius of the cornea [ 22 ]. The size of the infiltrate/scar and epithelial defect size were calculated by geometric mean of longest diameter and longest perpendicular, respectively [ 23 ].…”