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Christine M Sanfilippo, Heleen H DeCory, Daniel F Sahm, Penny A Asbell; Antibiotic Resistance Profiles of Ocular Pathogens – An Update from the 2015 ARMOR Surveillance Study. Invest. Ophthalmol. Vis. Sci. 2016;57(12):5404.
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© ARVO (1962-2015); The Authors (2016-present)
Antibiotic resistance is a concern in the treatment of bacterial infections of the eye. The ARMOR (Antibiotic Resistance Monitoring in Ocular micRoorganisms) study is the only ongoing nationwide antibiotic resistance surveillance program specific to ocular pathogens. Here we report results to date for ocular isolates collected in 2015.
Isolates of Staphylococcus aureus, coagulase-negative staphylococci (CoNS), Streptococcus pneumoniae, Pseudomonas aeruginosa, and Haemophilus influenzae were collected and subjected to antibiotic susceptibility testing. Minimum inhibitory concentrations were determined by broth microdilution for up to 15 antibiotics according to the Clinical and Laboratory Standards Institute guidelines. Isolates were categorized as susceptible or non-susceptible (intermediate and resistant) based on systemic breakpoints, where available.
A total of 441 isolates were collected from 19 US sites. Compared to 2014, non-susceptibility rates for S. aureus and CoNS generally remained steady. Resistance among the staphylococci was most notable for azithromycin (54-59%), oxacillin/methicillin (24-45%), and ciprofloxacin (22-28%), while CoNS isolates also exhibited high levels of non-susceptibility to tobramycin (19%) and trimethoprim (26%). In 2015, 20% of S. aureus isolates and 39% of CoNS isolates were non-susceptible to three or more drug classes, with multidrug resistance remaining prevalent among methicillin-resistant (MR) S. aureus (67%) and MRCoNS (74%). Isolates of S. pneumoniae remained susceptible to fluoroquinolones and chloramphenicol, while non-susceptibility to azithromycin and penicillin was 50% and 38%, respectively. Resistance among P. aeruginosa isolates continued to be low, although some non-susceptibility to polymyxin B (7%) was observed in 2015. As in 2014, H. influenzae isolates from 2015 were generally susceptible to all antibiotics tested.
Preliminary 2015 ARMOR surveillance data show continued high levels of antibiotic resistance among staphylococci, especially among MR strains, with many isolates demonstrating multidrug resistance. Susceptibility data obtained from ARMOR should be considered before initiating empiric treatment of common eye infections, and continued surveillance of ocular pathogens is warranted.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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