Update on the Epidemiology and Antibiotic Resistance of Ocular Infections
Abstract
PURPOSE: The purpose of this review is to provide an update on the epidemiology and current antibiotic-resistant threats in ophthalmology.
METHODS: Trends in frequency and antibiotic-nonsusceptible profiles during an 11 year-period (2005-2015) were evaluated and compared with the 5-year Antibiotic Resistance Monitoring in Ocular Microorganism (ARMOR) study.
RESULTS: Trends in the current review confirmed the continued high rates of fluoroquinolone nonsusceptbility circulating among ocular methicillin-susceptible Staphylococcus aureus, methicillin-susceptible Staphylococcus epidermidis, methicillin-resistant S. aureus, and methicillin-resistant S. epidermidis isolates as well as the detection of uncommon, but emerging resistance (<5%) for Streptococcus pneumoniae, Streptococcus viridans group, Haemophilus influenzae, and Pseudomonas aeruginosa. We documented significant differences in empirical fluoroquinolone and aminoglycoside coverage for the top three ocular pathogens (coagulase-negative staphylococci, S. aureus, and P. aeruginosa) in general and for corneal isolates between the Miami and the ARMOR studies. Collectively, the coverage for Miami was 74% versus 65.9% for ARMOR (P < 0.0001, 5.3674-10.8042) for ciprofloxacin and 95.9% versus 84.2% for aminoglycosides (gentamicin/tobramycin) (P < 0.0001, 9.9925-13.3974). Monotherapy coverage for ciprofloxacin and levofloxacin for the most recent 5 years (2011-2015) was 76.6% and 77.1%, respectively. Combination therapy with a…
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