Does in vitro susceptibility predict clinical outcome in bacterial keratitis?
Does in vitro susceptibility predict clinical outcome in bacterial keratitis?
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DOI：
10.1016/j.ajo.2007.11.004
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发表时间：
2008-03-01
影响因子：
4.2
通讯作者：
Acharya, Nisha R.
中科院分区：
文献类型：
--
作者：
Chen, Aiyin;Prajna, Lalitha;Acharya, Nisha R.
目得：为了确定细菌性角膜炎的临床结果是否与抗生素susceptibility.DESIGN：回顾性，辅助研究使用的数据和样本从一个完整的随机clinical trial.METHODS：42例患者参加了培养证实的细菌性角膜炎在Aravind眼科医院在印度南部。所有患者均接受外用阿托沙星，并随机接受外用磷酸泼尼松龙或安慰剂。结果包括上皮形成时间、最佳矫正视力（BSCVA）和3个月时的浸润/瘢痕大小。对分离菌株进行培养，用Etests法测定其对氟喹诺酮类药物的最低抑菌浓度（MIC）。多元线性回归用于评估MIC对结果的影响，调整入组特征。结果：MIC与3个月浸润/瘢痕大小相关：MIC每增加2倍，瘢痕大小平均直径增加0.33 mm（P = 0.01）。MIC与3个月BSCVA（P = 0.71）或上皮形成时间（P = 0.35）无关。结论：MIC与细菌性角膜炎的浸润/瘢痕大小相关。一项正在进行的大型多中心试验应该提供更多关于这种关联是否在微生物亚组中保持的信息。
PURPOSE: To determine whether clinical outcomes in bacterial keratitis are associated with antibiotic susceptibility.DESIGN: Retrospective, ancillary study using data and samples from a completed randomized clinical trial.METHODS: Forty-two patients were enrolled with culture-confirmed bacterial keratitis at Aravind Eye Hospital in South India. All patients received topical moxifloxacin and were randomized to receive either topical prednisolone phosphate or placebo. Outcomes included time to epithelialization, best spectacle-corrected visual acuity (BSCVA), and infiltrate/scar size at three months. Bacterial isolates were Cultured, and minimum inhibitory concentration (MIC) to moxifloxacin was measured using Etests. Multiple linear regression was used to assess the effect of MIC on outcome, adjusting for enrollment characteristics.RESULTS: MIC was associated with three-month infiltrate/scar size: each two-fold increase in MIC was associated with a 0.33-mm average diameter increase in scar size (P = .01). MIC was not associated with three-month BSCVA (P = .71) or time to epithelialization (P = .35).CONCLUSIONS: MIC was associated with infiltrate/scar size in bacterial keratitis. An ongoing larger, multicenter trial should provide further information on whether this association is maintained across subgroups of organisms.