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Susanna Sagerfors, Birgitta Ejdervik Lindblad, Bo Söderquist; Infectious keratitis: isolated microbes and their antibiotic susceptibility pattern during 11 years in Region Örebro County, Sweden. Invest. Ophthalmol. Vis. Sci. 2018;59(9):3678.
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© ARVO (1962-2015); The Authors (2016-present)
Infectious keratitis is a potentially sight-threatening infection that needs empirically guided antibacterial treatment before culture results are available. We performed a retrospective study of medical records to describe causative microorganisms and their antibiotic susceptibility patterns in infectious keratitis during an 11-year period at the three ophthalmological departments, of which one is a tertiary corneal referral center, in Region Örebro County, Sweden.
Patients with suspected infectious keratitis who underwent corneal culture between 1 January 2004 and 31 December 2014 were included if they met at least one of two inclusion criteria 1) positive corneal culture (all growth was considered positive) 2) and/or stromal infiltration with overlying epithelial defect in combination with at least one of the following; lesion within or overlapping the central 4 mm of the cornea and/ or uveitis and/ or pain. Data were obtained from medical records. A total of 398 episodes of infectious keratitis in 392 patients were included, of which 57% were women. The median age was 49.5 years.
Corneal cultures were positive in 285 of 398 episodes (71.6%). There was no statistically significant difference (p=0.11) in corneal culture outcome between the group of patients who were cultured prior to antibiotic treatment and the group who were not. However, a statistically significantly higher number of cultures with polymicrobial growth were detected in the group not treated with antibiotics prior to culture in comparison to those treated with antibiotics prior to culture (p=0.005). Coagulase-negative staphylococci (39%) were the most commonly isolated type of organism. Most commonly isolated microbes not considered commensal were Staphylococcus aureus (15%) followed by Pseudomonas aeruginosa (7%) and Corynebacterium macginleyi (4%). Reduced sensitivity to fluoroquinolones was observed in 5 of 43 S. aureus isolates and in 1 of 19 P. aeruginosa isolates.
Due to the spectrum of isolated microbes and their antibiotic susceptibility pattern, we recommend, in a setting similar to the one we have studied, empiric therapy with topical fluoroquinolones and chloramphenicol for bacterial keratitis after obtaining corneal cultures.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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