<p>Nine-year analysis of isolated pathogens and antibiotic susceptibilities of microbial keratitis from a large referral eye center in southern China</p>

Abstract

Purpose: To analyze the genus profile of isolated pathogens and antibiotic susceptibility trends of microbial keratitis over nine years at a large referral eye center in southern China. Methods: Data of corneal specimens from January 2010 to August 2018 of patients clinically diagnosed with infectious keratitis were obtained from the center’s microbiology database. Results with positive cultures along with antibiotic susceptibility were reviewed and analyzed. Results: We collected and reviewed 7,229 specimens, including 3,092 with positive cultures. Among them, 1,630 (52.72%) were bacterial, 1781 (57.60%) were fungal, and 319 (10.32%) were coinfected. A significant decreasing trend was observed in the isolates of Gram-positive cocci (r =−0.711, P =0.032), among which the proportion of coagulase-negative staphylococcus (CNS) was also reduced (r =−0.883, P =0.002). In contrast, an increasing trend in the proportion of Gram-negative bacilli was observed (r=0.661, P =0.053). The susceptibility rates of Gram-positive cocci to cephalosporins were near 90%, which was relatively high compared to fluoroquinolones. Fluoroquinolones represented the antibiotics to which Gram-negative bacilli were the most susceptible. Their susceptibility to moxifloxacin was 78.79%. The overall performance of aminoglycosides and vancomycin was both around 70%. The susceptibility of Gram-positive cocci to several antibiotics including levofloxacin (r=−0.717, P =0.03), tobramycin (r= −0.933, P <0.001), cefazolin (r= −0.964, P <0.001), ceftazidime (r=−0.929, P =0.003), chloramphenicol (r=−0.929, P =0.003), and cefuroxime (r=−0.829, P =0.042) decreased over time. The susceptibility of Gram-negative bacilli to ofloxacin increased over time (r=0.854, P =0.004), whereas that to cefazolin (r=−0.833, P =0.005) and chloramphenicol (r=−0.886, P =0.019) decreased over time. Conclusion: From 2010 to 2018 in Zhongshan Ophthalmic Center, most isolates from infectious keratitis were Gram-positive cocci (mainly CNS), which decreased over time, with an increase in Gram-positive bacilli. More than half of the antibiotics showed reducing trend of susceptibilities, and the antibiotic resistance situation in southern China was not encouraging.

Epidemiology, Drug Resistance, and Virulence of Staphylococcus aureus Isolated from Ocular Infections in Polish Patients

“…Chinese research on corneal infections caused by SA confirmed the lowest resistance of the strains to neomycin (Wang et al 2016). The possibility of treatment with the aminoglycoside group was confirmed independently by studies by Blanco and coworkers and Lin and coworkers, which showed high susceptibility of those strains to chloramphenicol (Blanco et al 2013;Lin et al 2019). Our results also confirm the high susceptibility of the SA isolates to fluoroquinolones and chloramphenicol.…”

“…Similar findings came from Canada and Europe (Asencio et al 2014;Assaad et al 2015). A Chinese analysis of corneal samples have provided that Gram-positive cocci (69.88%) are the most commonly isolated; nevertheless, a decreasing trend was observed over the nine years of the study (Lin et al 2019).…”

12-year analysis of incidence, microbiological profiles and in vitro antimicrobial susceptibility of infectious keratitis: the Nottingham Infectious Keratitis Study

“… 21 Another large study conducted in the Southern China similarly reported a predominance of fungal keratitis in the region. 22 The variation of microorganisms is likely influenced by various factors, including the occupational risk of corneal trauma, agricultural industry, use of contact lens, national income and others. 1 8 …”

Etiology, microbiological isolates, and antibiotic susceptibilities in culture-proven pediatric endophthalmitis: a 9-year review

“…Subsequently, the broth was inoculated onto sheep blood agar and potato glucose agar for the growth of bacterial cultures and fungal cultures, respectively. [15][16][17]. All bacterial isolates were subjected to species identification on an automated microbiological system Vitek 2 Compact (BioMerieux, Inc., Marcy-l'Étoile, France); all fungi isolates were identified by experienced technicians according to fungal morphology.…”