April 2011
Volume 52, Issue 14
ARVO Annual Meeting Abstract  |   April 2011
Antibiotic Resistance Trends in Ocular Pathogens - An Update From the ARMOR 2009 and ARMOR 2010 Surveillance Studies
Author Affiliations & Notes
  • Wolfgang Haas
    Bausch & Lomb, Inc., Rochester, New York
  • Chris M. Pillar
    Eurofins Medinet, Chantilly, Virginia
  • Timothy W. Morris
    Bausch & Lomb, Inc., Rochester, New York
  • Dan F. Sahm
    Eurofins Medinet, Chantilly, Virginia
  • Footnotes
    Commercial Relationships  Wolfgang Haas, Bausch & Lomb, Inc. (E); Chris M. Pillar, Bausch & Lomb, Inc. (C); Timothy W. Morris, Bausch & Lomb, Inc. (E); Dan F. Sahm, Bausch & Lomb, Inc. (C)
  • Footnotes
    Support  Bausch & Lomb, Inc.
Investigative Ophthalmology & Visual Science April 2011, Vol.52, 5844. doi:
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      Wolfgang Haas, Chris M. Pillar, Timothy W. Morris, Dan F. Sahm; Antibiotic Resistance Trends in Ocular Pathogens - An Update From the ARMOR 2009 and ARMOR 2010 Surveillance Studies. Invest. Ophthalmol. Vis. Sci. 2011;52(14):5844.

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

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Purpose: : Antibiotic resistance is a serious concern in the treatment of bacterial infections of the eye. The ARMOR (Antibiotic Resistance Monitoring in Ocular MicRorganisms) surveillance study was initiated in 2009 to monitor resistance trends among bacterial pathogens of ocular significance. Here we report the study results for the year 2010.

Methods: : Thirty-four sites were enrolled to submit ocular isolates of Streptococcus pneumoniae, Staphylococcus aureus, coagulase-negative staphylococci (CNS), Pseudomonas aeruginosa, and Haemophilus influenzae for antibiotic susceptibility testing. Broth microdilution minimum inhibitory concentrations were determined for 14-16 representative antibiotics against 274 isolates per Clinical and Laboratory Standards Institute methods. Isolates were categorized as susceptible, intermediate, or resistant based on systemic breakpoints (where available).

Results: : Compared to 2009, non-susceptibility to penicillin remained steady at 5% among S. pneumoniae isolates, although more strains were resistant in 2010 and fewer were intermediate. Azithromycin resistance rose to 29% in S. pneumoniae. An increase in resistance to azithromycin and oxacillin was noted for S. aureus and CNS isolates and moxifloxacin resistance increased in S. aureus. Among all staphylococci, non-susceptibility rates (isolates that were drug resistant or intermediate) were 39% for moxifloxacin, 40 - 41% for gatifloxacin, 65-76% for azithromycin, and 51-63% for oxacillin. In addition, 22% of S. aureus isolates were resistant to clindamycin in 2010, showing an increase over the previous year. Imipenem resistance increased to 16% in P. aeruginosa, while tobramycin resistance decreased. As in 2009, H. influenzae isolates from 2010 were generally susceptible to all test agents.

Conclusions: : The 2010 ARMOR surveillance data show a general increase in drug resistance, especially among the already problematic staphylococcal isolates, which show an increase in resistance for 3-4 classes of antibiotics. These results indicate the need for judicious use of antibiotic therapy in the treatment of ocular infections and the importance of ongoing, prospective, multi-center surveillance studies of ocular pathogens.

Keywords: bacterial disease • antibiotics/antifungals/antiparasitics • clinical (human) or epidemiologic studies: prevalence/incidence 

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