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Herlinda Mejia-Lopez, Lucero Martínez-López, Alejandro Clinent-Flores, Aida Rodríguez-Tovar, Luis Bautista-Hernández, Victo Bautista de Lucio, María Martínez-Rivera; In vitro analysis of the effect of steroid in combination with antimicrobial on co-cultures of bacteria and fungi isolated from keratitis. Invest. Ophthalmol. Vis. Sci. 2013;54(15):4298. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
Some of major diseases affecting the cornea are keratitis and may be of various origins including microbial, Currently, as a result of various risk factors such as frequent use of broad spectrum antibiotics and topical steroids, the self-medication, use of contact lenses, chronic systemic diseases, immunosuppression, among others, increased frequency of keratitis. Clinical manifestations depend on the causative agent; however, misdiagnosis generates chronicity with possibility of multiple treatments. The aim of this study was to analyze, in vitro, the effect of steroids in combination with antimicrobial agents on the growth of bacteria and fungi isolated from keratitis, as well as their co-cultures.
Aspergillus fumigatus, Fusarium solani, Staphylococcus aureus and Staphylococcus epidermidis isolated from patients with keratitis whom received multiple treatments, were studied. Minimum inhibitory concentration of amphotericin B and itraconazole and moxifloxacin and gatifloxacin were determinated. The effect of the dexamethasone and prednisolone on fungal or bacterial growth, individually and in co-cultures fungus-bacteria was studied also. Experiments were performed six times and analyzed by the ANOVA test to calculate the significance with respect to the untreated controls.
The growth of Fusarium solani was inhibited by the presence of prednisolone at 312.5 mg/mL (p ≤ 0.005). On the contrary, the growth of Aspergillus fumigatus was increased in presence of dexamethasone at 2.22 ug/ml and 570.0 mg/mL concentrations (p ≤ 0.05). There was no effect of corticosteroids on growth of bacteria. Moxifloxacin reduced the growth of F. solani dose-dependent manner. The antifungal combination with corticosteroids or quinolones favors the growth of fungi. S. aureus in coculture with A. fumigatus and prednisolone favored the growth of this fungus.
The cortiesteroids has dose-dependent inhibition effect on the growth of F. solani and A. fumigatus; similarly moxifloxacin on F. oxysporum. Combination of corticosteroids-antifungal as well as corticosteroids-quinolones favors growth of both fungi. In co-culture of S. aureus with A. fumigatus treated with prednisolone, the bacterium favored the growth of the fungus.
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