An 18-year review of pseudomonas keratitis: clinical characteristics, antibiotic susceptibility and treatment outcome

Session Details

Session Title: Cornea
Session Date/Time: Friday 10/02/2017 | 08:30-10:00
Paper Time: 08:30
Venue: Brussels Room 0.4

First Author: S.Lee SOUTH KOREA
Co Author(s): C. Cho                  

Abstract Details

Purpose:

In this study we investigated pathogenic organisms, antibiotic susceptibility, and clinical characteristics of patients with Pseudomonas species keratitis and evaluated risk factors of poor visual outcome.

Setting:

Retrospective, case-control study. All of study case were taken by Department of Ophthalmology, Yeungnam University College of Medicine, South Korea.

Methods:

Seventy six episodes of microbiologically confirmed Pseudomonas species keratitis were identified from January 1998 through December 2015. This study was divided into three periods(1998-2003, 2004-2009, 2010-2015) for analysis of the epidemiology, the bacteriological profiles, clinical characteristics, in vitro antibiotic susceptibility. Logistic regression analysis was performed to determine the risk factors of poor visual outcome. Poor visual outcome was defined as final best corrected visual acuity less than 0.1.

Results:

Pseudomonas aeruginosa was the most commonly isolated organism(42 eyes, 55.3%), followed by Pseudomonas putida(19 eyes, 25.0%), and other Pseudomonas species(15 eyes, 19.7%). Pseudomonas putida increased from 0.0% to 42.9% between the 1st and 3rd periods(p=0.002). The effective antibiotics against Pseudomonas species were colistin(100.0%), cefepime(95.7%), ciprofloxacin(94.4%), and meropenem(94.0%). According to analysis of predisposing factors, contact-lens was decreased from 66.7% to 14.3% between 1st and 3rd period, while corneal trauma was increased from 13.3% to 51.4%. In multivariate logistic regression, risk factors of poor visual outcome were epithelial defect size over 5mm2(p=0.041), following previous ocular surface disease(p=0.110) and previous ocular surgery(p=0.160).

Conclusions:

Pseudomonas aeruginosa was the most common isolate of this study. Over the three periods, percentage of Pseudomonas putida keratitis and corneal trauma were increased. Shifting trends of the antibiotics resistance rate were not significant in most of the antibiotics except aztreonam. The major risk factor of poor visual outcome was epithelial defect size over 5mm2. When diagnosed with a Pseudomonas keratitis, we might consider proper antibiotics according to antimicrobial susceptibility including ciprofloxacin, cefepime, meropenem and colistin.

Financial Disclosure:

None