Integrated analysis of three bacterial conjunctivitis trials of besifloxacin ophthalmic suspension, 0.6%: etiology of bacterial conjunctivitis and antibacterial susceptibility profile

Abstract

BackgroundThe purpose of this paper is to report on the bacterial species isolated from patients with bacterial conjunctivitis participating in three clinical trials of besifloxacin ophthalmic suspension, 0.6%, and their in vitro antibacterial susceptibility profiles.MethodsMicrobial data from three clinical studies, conducted at multiple clinical sites in the US and Asia were integrated. Species were identified at a central laboratory, and minimum inhibitory concentrations were determined for various antibiotics, including β-lactams, fluoroquinolones, and macrolides.ResultsA total of 1324 bacterial pathogens representing more than 70 species were isolated. The most common species were Haemophilus influenzae (26.0%), Streptococcus pneumoniae (22.8%), Staphylococcus aureus (14.4%), and Staphylococcus epidermidis (8.4%). H. influenzae was most frequently isolated among patients aged 1–18 years, while S. aureus was most prevalent among those >65 years. Drug resistance was prevalent: Of H. influenzae isolates, 25.3% were β-lactamase positive and 27.2% of S. pneumoniae isolates were penicillin-intermediate/ resistant; of S. aureus isolates, 13.7% were methicillin-resistant (MRSA), and of these, 65.4% were ciprofloxacin-resistant, while 45.9% of S. epidermidis isolates were methicillin-resistant (MRSE), and, of these, 47.1% were ciprofloxacin-resistant. Besifloxacin was more potent than comparator fluoroquinolones overall, and particularly against Gram-positive bacteria. Against ciprofloxacin-resistant MRSA and MRSE, besifloxacin was four-fold to ≥ 128-fold more potent than other fluoroquinolones.ConclusionsWhile the pathogen distribution in bacterial conjunctivitis has not changed, drug resistance is increasing. Patient age and local antibiotic resistance trends should be considered in the treatment of this ocular infection. Besifloxacin showed broad-spectrum in vitro activity and was particularly potent against multidrug-resistant staphylococcal isolates.

Characterization of baseline polybacterial versus monobacterial infections in three randomized controlled bacterial conjunctivitis trials and microbial outcomes with besifloxacin ophthalmic suspension 0.6%

“…the treatment of bacterial conjunctivitis. A chlorinated fluoroquinolone, besifloxacin has potent activity against both Gram-positive and Gram-negative bacteria, including multidrugresistant strains [25][26][27], and is rapidly bactericidal [28][29][30]. Besifloxacin is formulated with DuraSite 1 (Sun Pharma Global FZE), which helps increase retention on the ocular surface, and has demonstrated effectiveness in several bacterial conjunctivitis clinical trials [31][32][33][34][35][36].…”

Phenotypic, molecular characterization, antimicrobial susceptibility and draft genome sequence of Corynebacterium argentoratense strains isolated from clinical samples

“…Moreover, if this organism is responsible for pharyngotonsillitis, and if patients are to be empirically treated with penicillins based on a suspicion of a Streptococcus pyogenes infection, such a treatment could be ineffective in some cases, as inferred by the antimicrobial susceptibility data obtained in this study. The isolation of C. argentoratense from intravenous sites in patients with cancer [6] and from the conjunctival fornix in patients with conjunctivitis [7] is of interest and also merits further investigation.…”

“…This report probably includes the four isolates previously referred to in the taxonomic description of C. argentoratense [1] . In addition to these nine isolates, this organism has been isolated from blood cultures of patients in Canada [4] and Saudi Arabia [5] , from intravenous sites (catheter and blood) of cancer patients [6] , from the conjunctiva of patients with bacterial conjunctivitis [7] and as part of a mucosal biofilm in the adenoid tissue of a child with otitis media [8] . Table 1 summarizes the sources, geographical origins and clinical data of the C. argentoratense isolates described so far.…”

Draft Genome Sequences of the Two Unrelated Macrolide-Resistant Corynebacterium argentoratense Strains CNM 463/05 and CNM 601/08, Isolated from Patients in the University Hospital of León, Spain

“…It was initially isolated from patients suffering tonsillitis in Strasbourg, France ( 2 , 3 ). Since the first isolation of C. argentoratense , it has been obtained from the respiratory tract of humans ( 4 ), blood cultures ( 5 , 6 ), intravenous sites ( 7 ), ear ( 4 ), and conjunctival fornix ( 8 ) and from adenoid tissues associated with otitis media ( 9 ). The complete genome sequence of the type strain C. argentoratense IBS B10697 T (DSM 44202) comprises 2,031,902 bp, revealing so far the smallest sequenced genome of a corynebacterial species associated with humans ( 10 ).…”