Abstract
Purpose :
To assess trends in microbiology profiles and antibiotics susceptibility among pediatric infectious keratitis cases at UCLA Stein Eye Institute.
Methods :
This is a retrospective chart review study. Patients 18 years and younger diagnosed with infectious keratitis with a positive microbiology culture between 2006-2019 were included. Demographics, microbiology results, and antibiotic susceptibilities were analyzed and reported.
Results :
In total, 20 patients were identified. Mean age of the patients was 11 years old (range: 0 to 18) with 60% being ≥10 years old. Fifteen were female (75%), and 45% were of Hispanic/Latino origin. Most patients (n=14) presented between June and November. Both eyes were affected equally.
26 microorganisms were reported from 20 corneal cultures. Among them, bacteria was found in 92%, with one isolate (4%) each of fungi (Candida parapsilosis) and virus (HerpesSimplex). The most common bacterial isolates was Pseudomonas aeruginosa (23%). Among Gram-positive group (n=13), Staphylococcus infections were the most prevalent (n=5): four Coagulase-negative Staphylococcus, and one methicillin-resistant Staphylococcus aureus. Only 19% of Gram-positive isolates were susceptible to Trimethoprim-Sulfamethoxazole, and 8% susceptible to Erythromycin. However, all Gram-positive isolates were susceptible to Vancomycin. Among the Gram-negative bacteria (n=11), six were Pseudomonas aeruginosa, and three were Moraxella. 82% of Gram-negative bacteria were susceptible to Gentamicin, 64% to Ciprofloxacin, and 55% to Ceftazidime. Pseudomonas isolates in the cohort were highly sensitive to Gentamicin (100%) and Ciprofloxacin (83%), and moderately sensitive to tobramycin (67%) and ceftazidime (67%).
Conclusions :
Pseudomonas aeruginosa was the most common organism responsible for pediatric microbial keratitis cases and was highly susceptible to gentamicin and ciprofloxacin. Empiric therapies with trimethoprim-sulfamethoxazole or erythromycin may be insufficient for Gram-positive antimicrobial coverage in children, and clinicians should consider the addition of vancomycin with tobramycin or gentamicin. Empiric coverage with tobramycin and gentamicin suggested for Pseudomonas and Gram-negative infections.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.