June 2015
Volume 56, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2015
Correlation of P. aeruginosa Type III Secretion Profiles Diversity and Ocular Disease Syndromes
Author Affiliations & Notes
  • Jorge Maestre
    Ophthalmology, University of Miami, Miami, FL
  • Edith Perez
    Ophthalmology, University of Miami, Miami, FL
  • Eduardo C Alfonso
    Ophthalmology, University of Miami, Miami, FL
  • Harry W Flynn
    Ophthalmology, University of Miami, Miami, FL
  • Darlene Miller
    Ophthalmology, University of Miami, Miami, FL
  • Footnotes
    Commercial Relationships Jorge Maestre, None; Edith Perez, None; Eduardo Alfonso, None; Harry Flynn, None; Darlene Miller, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2015, Vol.56, 4045. doi:
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      Jorge Maestre, Edith Perez, Eduardo C Alfonso, Harry W Flynn, Darlene Miller; Correlation of P. aeruginosa Type III Secretion Profiles Diversity and Ocular Disease Syndromes. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):4045.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: Pseudomonas aeruginosa associated ocular infections are among the most diverse and difficult to manage. Clinical presentations and pathology range from purulent conjunctivitis and ulcerative keratitis to invasive scleritis and persistent, destructive biomaterial centered infections. Virulence, disease course and patient outcomes are strain specific. We used a combination of molecular, metabolic and in vitro resistance markers to determine and correlate Pseudomonas aeruginosa Type lll effector protein (T3SS) profiles with biochemical patterns, ocular disease presentations and in vitro susceptibility.

Methods: Type III Profiles: A multiplex PCR was used to characterize and compare the prevalence of exoS (invasive), exoT (invasive), exoU (cytotoxic) and exoY (adenyl cyclase) (genotypes for 155 Pseudomonas aeruginosa strains collected from ocular sources (cornea-n=96, contact lens-n=20, conjunctiva-n=23, lacrimal system-n=8, Intraocular fluids-n=8) from 2008 to 2014. Biochemicals and vitro susceptibility profiles were determined using the Vitek 2 system.

Results: Exo Y and T effector proteins were detected in all 155 isolates, while exoS ( N=70) and exoU (N=63) were generally mutually exclusive. Prevalence of the four identified genotypes were exoS+U- (45.2%), exoS-U+ (40.6%), exoS+U+ (7%) and exoU-S- (9.7%). ExoU (cytotoxic strain) was the predominant profile of isolates recovered from cornea (46.9%) and contact lens cases (70%) but was evident in all sources. ExoS genotypes were documents in 50% or higher for isolates recovered from conjunctiva (56.5%), intraocular fluids (50%) and lacrimal system (50%). Strains with absence of T3SS effectors were seen most often in isolates associated with conjunctivitis (34.8%).<br /> No significant correlation of metabolic profiles (N=100) were associated with these isolates. Strains with genotype exoS-U+ had the higher MIC90 (1 ug/ml) for ciprofloxacin vs 0.5 ug/ml or less for exoS+U- and exoU-S- . Ciprofloxacin resistance ranged from 1% (cornea) to 6% (conjunctiva). MIC90 for moxifloxacin was 2 ug/ml and ranged from 3% (cornea) to 8% (conjunctiva and lacrimal system).

Conclusions: Ocular Pseudomonas aeruginosa strains are diverse and associated with specific disease syndromes and antibiotic profiles. Characterizing the T3SS profiles may serve as an important adjunct in understanding the pathology and management of these destructive and recalcitrant infections

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