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Penny A Asbell, Christine M Sanfilippo, Daniel F Sahm, Heleen H DeCory; Antibiotic Resistance Among Ocular Pathogens - Results from the ARMOR Surveillance Study 2013-Present . Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):284.
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© ARVO (1962-2015); The Authors (2016-present)
The Antibiotic Resistance Monitoring in Ocular micRoorganisms (ARMOR) study was initiated in 2009 to survey resistance levels among ocular pathogens on a nationwide scale. Here we report the complete study results for 2013 compared to preliminary 2014 data.
Isolates of Streptococcus pneumoniae, Staphylococcus aureus, coagulase-negative staphylococci (CoNS), Pseudomonas aeruginosa, and Haemophilus influenzae were subjected to antibiotic susceptibility testing. In 2013, 543 isolates were collected from 22 sites; 140 isolates have been collected from 7 sites to date in 2014. Minimum inhibitory concentrations were determined by broth microdilution for up to 16 representative antibiotics per CLSI methods. Systemic breakpoints (where available) were used to categorize isolates as susceptible or non-susceptible (intermediate and resistant).
With the exception of a fluoroquinolone-resistant isolate and an azithromycin-resistant isolate observed in 2014, all H. influenzae isolates were susceptible to all drugs tested. Isolates of P. aeruginosa in 2013 were non-susceptible to polymyxin B (27%), imipenem (16%), and ciprofloxacin (9%); no resistance was detected in 2014. Compared to 2013, non-susceptibility rates for 2014 S. pneumoniae isolates more than doubled for penicillin (26% vs. 53%), azithromycin (31% vs. 63%), and chloramphenicol (2% vs. 11%). Isolates of S. aureus in 2014 were non-susceptible to oxacillin (28%), ciprofloxacin (22%), and azithromycin (53%), showing decreases from the previous year. From 2013 to 2014, tobramycin non-susceptibility among CoNS increased substantially (35%) while azithromycin and oxacillin resistance rates only slightly increased (65% and 63%, respectively); other CoNS susceptibilities generally remained steady. While multi-drug resistance (MDR) in 2014 decreased among S. aureus (16%) and methicillin-resistant (MR) S. aureus (50%), MDR among CoNS and MRCoNS increased to 55% and 84%, respectively.
To date, the 2014 ARMOR surveillance data show increased drug non-susceptibility rates among S. pneumoniae isolates and high levels of multi-drug resistance in the already problematic staphylococci. Continued surveillance of ocular pathogens is necessary in order to provide healthcare professionals with the awareness of evolving trends in antimicrobial susceptibility patterns to effectively guide the treatment of ocular infections.
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