Bacterial Keratitis: Isolated Organisms and Antibiotic Resistance Patterns in San Francisco
Bacterial Keratitis: Isolated Organisms and Antibiotic Resistance Patterns in San Francisco
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DOI：
10.1097/ico.0000000000001417
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发表时间：
2018-01-01
期刊：
影响因子：
2.8
通讯作者：
Rose-Nussbaumer, Jennifer
中科院分区：
文献类型：
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作者：
Peng, Michelle Y.;Cevallos, Vicky;Rose-Nussbaumer, Jennifer
目的：在决定经验性抗生素治疗时，了解特定地理区域的病原体谱是很重要的。在这项研究中，我们评估了从角膜样本中培养出的细菌谱及其对抗生素的敏感性，以指导角膜炎的初步治疗。方法：我们对1996年至2015年在加州大学旧金山分校弗朗西斯·I·普罗科特基金会疑似感染性角膜炎病例中培养的细菌进行了回顾性病例回顾。用Logistic回归模型评估从溃疡中培养耐甲氧西林金黄色葡萄球菌(MRSA)的风险，以及培养年份与莫西沙星耐药性之间的关系。结果：在2203株培养物中，共有522株(23.7%)生长出被认为是感染病原菌的细菌，并提供了可用的抗生素敏感性数据。其中革兰氏阳性菌338株(65.3%)，最常见的是甲氧西林敏感的金黄色葡萄球菌(20.1%，N=105)。革兰氏阴性菌180株(34.7%)，以铜绿假单胞菌为主(10.9%，57株)。在控制感染菌后，培养日期每增加1年，培养耐莫西沙星菌的几率增加1.26(P<；0.001)。结论：革兰氏阳性菌是本组微生物角膜炎最常见的病原菌。大约35%的培养生物对莫西沙星有不同的敏感性，而且耐药性似乎随着时间的推移而增加。培养MRSA的风险随着时间的推移而增加。
Purpose: Understanding the spectrum of pathogens in a given geographic region is important when deciding on empiric antibiotic therapy. In this study, we evaluate the spectrum of bacterial organisms cultured from corneal samples and their antibiotic sensitivities to guide initial treatment of keratitis.Methods: We performed a retrospective case review of cultures from suspected infectious keratitis cases at the Francis I. Proctor Foundation, University of California, San Francisco, from 1996 through 2015. Logistic regression models were used to assess the risk of culturing methicillin-resistant Staphylococcus aureus (MRSA) from ulcers over time and the association between the year cultured and moxifloxacin resistance.Results: A total of 522 of 2203 (23.7%) cultures grew bacterial organisms believed to be the etiology of infection, with available antibiotic sensitivity data. Of these, 338 (65.3%) grew gram-positive organisms with the most common being methicillin-sensitive Staphylococcus aureus (20.1%, N = 105). One hundred eighty (34.7%) grew gram-negative species with Pseudomonas aeruginosa as the most prevalent organism (10.9%, N = 57). There was 1.13 increased odds of culturing MRSA for each 1-year increase in the culture date (P = 0.01) and 1.26 increased odds of culturing an organism resistant to moxifloxacin with each 1-year increase in the culture date after controlling for the infectious organism (P < 0.001).Conclusions: Gram-positive organisms are the most commonly identified etiology of microbial keratitis in this series. Approximately 35% of cultured organisms had variable susceptibility to moxifloxacin, and resistance seems to be increasing over time. The risk of culturing MRSA increased over time.