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C. M. Pillar, M. K. Torres, D. F. Sahm; Ten Year Trends and Current Activity Profile of Fluoroquinolones Among Ocular Isolates of S. aureus and S. epidermidis - Results From TSN® Surveillance. Invest. Ophthalmol. Vis. Sci. 2010;51(13):2412.
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© ARVO (1962-2015); The Authors (2016-present)
As ocular infections are generally treated empirically, it is important to understand the current activity profile of commonly utilized agents against primary ocular pathogens and to detect patterns of resistance. The Surveillance Network (TSN), an electronic database which collects large volumes of susceptibility testing data, allows for the monitoring and tracking of resistance trends. This study utilizes TSN data to evaluate the current fluoroquinolone (FQ) resistance trends in the US over the past 10 years among ocular isolates of S. aureus and S. epidermidis.
Susceptibility data as reported for >150 US clinical laboratories for oxacillin (OXA), ciprofloxacin (CIP), levofloxacin (LVX), gatifloxacin (GAT), and moxifloxacin (MXF) on >20,000 ocular S. aureus and >2,000 ocular S. epidermidis collected from 1999-2009 were evaluated. Interpretive resistance (R) criteria were defined based on breakpoints for systemic agents.
Among ocular S. aureus, methicillin resistance(MRSA) based on OXA MICs (N=21,896) has steadily increased from 25% in 1999 to over 45% in 2008. Resistance to CIP (N=12,480) and LVX (N=14,086) increased 10% from 1999-2002 and has fluctuated between 27% and 38% from 2002-2008. Among ocular S. epidermidis, methicillin resistance (MRSE) based on OXA MICs (N=2,195) ranged between 62% and 72% across the evaluated time period, with resistance to CIP (N=1,738) and LVX (N=1,607) increasing 20% from 2000-2004 and resistance in 2008 of 37% and 52% for CIP and LVX, respectively. Currently (2006-2009), ocular MRSA are 59%R to MXF (N=1,020), 64%R to CIP (N=1,444), 69%R to LVX (N=2,162) and 72%R to GAT (N=733), while ocular MRSE are 53%R to CIP (N=274), 57%R to MXF (N=92), 65%R to GAT (N=91), and 75%R to LVX (N=305).
Over time, there has been a steady increase in MRSA among ocular isolates in the US, with a substantial proportion of ocular MRSE across the evaluated period. Among ocular MRSA/MRSE, resistance to currently utilized FQs was common. As MRSA and MRSE are prevalent among ocular isolates, it is important to consider the potency of empiric ocular agents against these specific resistant subpopulations.
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