July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Asia Cornea Society Infectious Keratitis Study: Pseudomonas aeruginosa infectious keratitis
Author Affiliations & Notes
  • Roger W Beuerman
    AMOP, Singapore Eye esearch Institute, Singapore, Singapore, Singapore
    Neuroscience, Duke-NUS, Singapore, Singapore, Singapore
  • A. Mishra
    AMOP, Singapore Eye Research Institute, Singapore, Singapore, Singapore
  • AL Tan
    Microbiology, Singapore General Hospital, Singapore, Singapore
  • MH Periayah
    AMOP, Singapore Eye Research Institute, Singapore, Singapore, Singapore
  • X Lian
    AMOP, Singapore Eye Research Institute, Singapore, Singapore, Singapore
  • R Sultana
    Duke-NUS Medical School, Singapore, Singapore
  • SE Saffari
    Duke-NUS Medical School, Singapore, Singapore
  • WB Khor
    Singapore National Eye Center, Singapore, Singapore
  • Jodhbir Mehta
    Singapore National Eye Center, Singapore, Singapore
  • Donald Tan
    Singapore National Eye Center, Singapore, Singapore
  • Footnotes
    Commercial Relationships   Roger Beuerman, Santen (C); A. Mishra, None; AL Tan, None; MH Periayah, None; X Lian, None; R Sultana, None; SE Saffari, None; WB Khor, None; Jodhbir Mehta, Santen (C); Donald Tan, Santen (C)
  • Footnotes
    Support  Asia Cornea Foundation
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 854. doi:
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    • Get Citation

      Roger W Beuerman, A. Mishra, AL Tan, MH Periayah, X Lian, R Sultana, SE Saffari, WB Khor, Jodhbir Mehta, Donald Tan; Asia Cornea Society Infectious Keratitis Study: Pseudomonas aeruginosa infectious keratitis. Invest. Ophthalmol. Vis. Sci. 2019;60(9):854.

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

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Abstract

Purpose : Purpose: P. aeruginosais one of the leading pathogens associated with ocular infections. It is notorious because it is becoming difficult to treat due to antibiotic resistance.In the present study, antibiotic susceptibility profiles of P. aeruginosaisolated from infectious keratitis patients were tested. Antibiotics used for treatment and clinical outcomes were also compared.This prospective observational study was conducted over 12-18 months at thirteen study centers in China, India, Japan, South Korea, Taiwan, Philippines, Thailand and Singapore.

Methods : Methods: P. aeruginosa(n=222) were confirmed using MALDI-TOF at the Diagnostic Bacteriology Laboratory, Singapore General Hospital. Antibiotic susceptibilities were tested using customized panels from SensititreR, at Microbiology laboratory, Singapore Eye Research Institute. Susceptibility data was interpreted according to CLSI guidelines. Trial was registered as NCT01560208; all sites obtained local ethics approval.

Results : Results: P. aeruginosakeratitis was observed equally in males (49.5 %) and females (50.5 %) and was evenly distributed in all age groups. Contact lens wear was the commonest risk factor (55.0 %) followed by trauma (22. 2%). Infection completely resolved with treatment in 71.6 % patients. Infection was not resolved and acute surgical intervention was required in 7.2 % cases. In 1.8 % cases infection resolved but acute intervention was still required. Almost 18.5 % patients were lost to follow up. Susceptibility varied against different antibiotics – amikacin (99. 1 %), cefepime (98.6 %), ciprofloxacin (98.2), gentamicin (97.3 %), gatifloxacin (95.3 %), besifloxacin (91.4 %), moxifloxacin (89.5 %), piperacillin/ tazobactam (93.7 %), polymyxin B (95.9 %), tobramycin (97.3 %) and imipenem (20.7 %). Only five (2.2 %) isolates were resistant against all tested fluoroquinolones.Cefazolin, moxifloxacin, amikacin levofloxacin, ciprofloxacin, and gentamicin were prescribed in 50.0%, 21.1 %, 9.0%, 3.1%, 2.7 % and 2.7 % patients respectively. Interestingly 95.5% of patients on cefazolin received gentamicin as second antibiotic. Overall, 25.25 % and 2.25 % patients received a third and fourth antibiotic.

Conclusions : Conclusion: P. aeruginosaisolates were fairly susceptible against tested antibiotics. However, clinical outcomes in 9.0% of patients were still serious requiring surgical interventions.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

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