Abstract
Background. The bacteria isolated from severe cases of keratitis and their antibiotic sensitivity are recognised to vary geographically and over time. Objectives. To identify the most commonly isolated bacteria in keratitis cases admitted over a 24-month period to a public hospital in Auckland, New Zealand, and to investigate in vitro sensitivity to antibiotics. Methods. Hospital admissions for culture-proven bacterial keratitis between January 2013 and December 2014 were identified. Laboratory records of 89 culture positive cases were retrospectively reviewed and antibiotic sensitivity patterns compared with previous studies from other NZ centres. Results. From 126 positive cultures, 35 species were identified. Staphylococcus was identified to be the most common isolate (38.2%), followed by Pseudomonas (21.3%). Over the last decade, infection due to Pseudomonas species, in the same setting, has increased (p ≤ 0.05). Aminoglycosides, cefazolin, ceftazidime, erythromycin, tetracycline, and doxycycline were 100% effective against tested isolates in vitro. Amoxicillin (41.6%), cefuroxime (33.3%), and chloramphenicol (94.7%) showed reduced efficacy against Gram-negative bacteria, whereas penicillin (51%) and ciprofloxacin (98.8%) showed reduced efficacy against Gram-positive bacteria. Conclusions. Despite a shift in the spectrum of bacterial keratitis isolates, antibiotic sensitivity patterns have generally remained stable and show comparability to results within the last decade from NZ centres.
Highlights
Microbial keratitis (MK) is an ocular emergency that requires prompt and specific management to maximise visual outcome and preserve ocular integrity
Depending on the current laboratory protocols and the isolated organism, the following antimicrobial agents were included in susceptibility testing: penicillin, fluoroquinolone, cephalosporins, aminoglycoside, chloramphenicol, and tetracycline
The aim of the present study was to identify the current spectrum of bacteria causing keratitis leading to hospitalization in a tertiary care centre with a wide catchment area in Auckland, New Zealand, and to evaluate recent antibiotic susceptibility patterns
Summary
Microbial keratitis (MK) is an ocular emergency that requires prompt and specific management to maximise visual outcome and preserve ocular integrity. 77 species from 42 genera of bacteria have been identified to have a potential to cause keratitis [5] This diversity of organisms contributes to the need for targeted treatment. The treatment protocol based on clinical diagnosis alone has the benefit of allowing rapid intervention but does not provide confirmation of the causative organism which can otherwise be hard to identify due to overlapping clinical signs from different pathogens [6]. Despite a shift in the spectrum of bacterial keratitis isolates, antibiotic sensitivity patterns have generally remained stable and show comparability to results within the last decade from NZ centres
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