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Analysis of microbial keratitis incidence, isolates and in-vitro antimicrobial susceptibility in the East of England: a 6-year study.
- Source :
-
Eye (London, England) [Eye (Lond)] 2023 Sep; Vol. 37 (13), pp. 2716-2722. Date of Electronic Publication: 2023 Jan 28. - Publication Year :
- 2023
-
Abstract
- Background/objectives: To report the incidence, microbiological profile and in-vitro antimicrobial susceptibilities of microbial keratitis (MK) in the East of England (EoE) over a 6-year period.<br />Subjects/methods: A retrospective study of patients diagnosed with MK who underwent corneal scraping at participating trusts, within the EoE, between 01/01/2015-01/07/2020. Analysis was performed on MK isolate profiles, in-vitro anti-microbial sensitivities and trends over time.<br />Results: The mean incidence of IK, in the EoE, was estimated at 6.96 per 100 000 population/year. 1071 corneal scrapes were analysed, 460 were culture positive (42.95%) of which 87.2% were bacteria (50.3% gram-positive and 49.7% gram-negative), 2.4% polymicrobial, 9.3% fungi and 1.1% acanthamoeba. The most common organisms were pseudomonas spp (29.57%). There was a non-statistically significant trend (NST) in increasing incidence of pseudomonas spp, staph aureus and serratia (p = 0.719, p = 0.615, and p = 0.099 respectively) and a declining NST in Fungi (p = 0.058). Susceptibilities in-vitro to, penicillin classes, fluoroquinolone and aminoglycosides were 76.7% and 89.4%, 79.2% and 97.2% and 95.4 and 96.1% to gram-positive and gram-negative bacteria respectively. Gram-negative organisms were increasingly resistant to cephalosporins with a 19.2% reduction in sensitivity over time. (p = 0.011). Ceftriaxone showed the greatest decrease in sensitivity of 41.67% (p = 0.006).<br />Conclusion: In the EoE, MK is relatively prevalent though likely underestimated. Profiles are similar to other UK regions with the exception of a higher fungal and lower acanthamoeba incidence. Common first and second-line antimicrobial selection provides, on the whole, good coverage. Nevertheless, anti-microbial resistance, to cephalosporins, was observed so selection should be carefully considered when treating MK empirically.<br /> (© 2023. The Author(s), under exclusive licence to The Royal College of Ophthalmologists.)
- Subjects :
- Humans
Anti-Bacterial Agents pharmacology
Anti-Bacterial Agents therapeutic use
Retrospective Studies
Incidence
Gram-Negative Bacteria
Microbial Sensitivity Tests
Gram-Positive Bacteria
England epidemiology
Cephalosporins
Corneal Ulcer microbiology
Eye Infections, Bacterial microbiology
Keratitis drug therapy
Keratitis epidemiology
Keratitis diagnosis
Anti-Infective Agents
Subjects
Details
- Language :
- English
- ISSN :
- 1476-5454
- Volume :
- 37
- Issue :
- 13
- Database :
- MEDLINE
- Journal :
- Eye (London, England)
- Publication Type :
- Academic Journal
- Accession number :
- 36709219
- Full Text :
- https://doi.org/10.1038/s41433-023-02404-3