Gram-negative bacterial keratitis: a 15 year clinical and microbiological review in a university hospital in South Korea

Session Details

Session Title: Endophthalmitis/Ocular Infections

Session Date/Time: Wednesday 09/09/2015 | 08:00-09:30

Paper Time: 08:30

Venue: Room 8

First Author: : S.Lee SOUTH KOREA

Co Author(s): :    E. Cho   C. Cho                 

Abstract Details

Purpose:

The purpose is to investigate the shifting trends of pathogenic organisms and antibiotics resistance, and to analyze epidemiological, microbiological, and clinical characteristics of patients with Gram-negative bacterial keratitis (GNBK), and also to elucidate risk factors for unimproved visual outcomes.

Setting:

Department of Ophthalmology, Yeungnam University College of Medicine, Daegu, Korea

Methods:

We performed a retrospective chart review of 160 eyes, 169 isolates in 160 patients with GNBK between Jan 1998 and Dec 2012 at Yeungnam University Hospital. The study was divided into 5 periods for analysis of the bacteriological profiles and in vitro antibiotics sensitivity. The epidemiological and clinical characteristics were compared according to 4 groups: Pseudomonas spp.(PS), Enterobacter spp.(ES), S. marcescens (SM), S. maltophilia(STM).

Results:

GNBK tended to increase between 1998 and 2012. The prevalence of G(-) organisms increased from 34.7 to 73.2% between 1st and 5th periods (p<0.001). There was significant difference in GNBK isolates between 3rd(37.5%) and 4th(68.1%) period (p<0.001). PS was most commonly isolated organism (32.5%) in total period, followed by ES(24.3%), SM (19.5%), and STM (10.1%). The effective antibiotics against G(-) bacterial pathogens were levofloxacin (93.7%), ciprofloxacin(93.0%), amikacin(92.3%), and ceftazidime(89.9%). But ampicillin(2.4%), cefoxitin(34.3%), and cefotaxime(65.4%) were less effective antibiotics. SM had the shortest corneal epithelium healing time and the most favorable visual outcome after treatment compared with the other species. Risk factors for poor visual outcomes included a BCVA less than 0.1 at initial evaluation and central corneal lesion.

Conclusions:

GNBK tended to increase and PS was the most common isolate. The clinical prognosis was most favorable in SM. Empirical antibiotic selection should be based on local susceptibility patterns and distribution of bacterial isolates.

Financial Interest:

NONE