Abstract

PurposeTo describe the trends in pathogens and antibacterial resistance of corneal culture isolates in infectious keratitis during a period of 13 years at Hadassah-Hebrew University Medical Center.MethodsA Retrospective analysis of bacterial corneal isolates was performed during the months of January 2002 to December 2014 at Hadassah Hebrew University Medical Center. Demographics, microbiological data and antibiotic resistance and sensitivity were collected.ResultsA total of 943 corneal isolates were analyzed during a 13 year period. A total of 415 positive bacterial cultures and 37 positive fungal cultures were recovered, representing 48% of the total cultures. The Annual incidence was 34.78 ± 6.54 cases. The most common isolate was coagulase-negative staphylococcus (32%), which had a significant decrease in trend throughout the study period (APC = -8.1, p = 0.002). Methicillin-resistant Staphylococcus aureus (MRSA) appears to have a decrease trend (APC = -31.2, P = 0.5). There was an increase in the resistance trend of coagulase-negative staphylococci to penicillin (APC = 5.0, P = <0.001). None of the pathogens had developed any resistance to Vancomycin. (P = 0.88).ConclusionsCoagulase negative staphylococci were the predominant bacteria isolated from patients with keratitis. There was no significant change in the annual incidence of cases of bacterial keratitis seen over the past 13 years. Keratitis caused by MRSA appeared to decrease in contrast to the reported literature.

Highlights

  • Bacterial keratitis is a significant cause of visual loss

  • There was an increase in the resistance trend of coagulase-negative staphylococci to penicillin (APC = 5.0, P =

  • Coagulase negative staphylococci were the predominant bacteria isolated from patients with keratitis

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Summary

Introduction

Bacterial keratitis is a significant cause of visual loss. A targeted therapy based on corneal cultures and sensitivity of antibiotics is essential for the effective management of bacterial keratitis[1]. Empiric treatment should be started immediately and the antibiotic chosen should be of sufficiently broad spectrum to cover likely pathogens based on local bacterial prevalence and antibiotic susceptibilities.[2] Since regional differences exist in the etiologies of bacterial keratitis[3,4], good local epidemiological data are needed for better empirical treatment of bacterial keratitis. Many community-based ophthalmologists elect to treat bacterial keratitis with broad-spectrum antibiotics without corneal scraping and susceptibility results.[5] In our institution we routinely culture all cases of suspected bacterial keratitis and start combination therapy with topical fortified cefazolin and gentamicin

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