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Abstract：
OBJECTIVE: To examine the microbial distribution and antimicrobial susceptibility of culture-positive microbial keratitis at a large tertiary referral center in the mid-Atlantic region of the United States.
METHODS: Retrospective review of culture-positive microbial keratitis cases at the Wilmer Eye Institute from 2016 through 2020.
RESULTS: Of the 474 culture-positive microbial keratitis cases, most were bacterial (N=450, 94.9%), followed by fungal (N=48, 10.1%) and Acanthamoeba keratitis (N=15, 3.1%). Of the 450 bacterial isolates, 284 (69.5%) were gram-positive organisms, whereas 157 (28.4%) were gram-negative organisms. The most common bacterial species isolated was coagulase-negative Staphylococcus spp (N=154, 24.8%), and the most common gram-negative isolate was Pseudomonas aeruginosa (N=76, 12.3%). Among fungi, the most common isolates were Candida (N=25, 45.4%), whereas Fusarium (N=6, 10.9%) and Aspergillus (N=3, 5.5%) were less common. Of the 217 bacterial isolates tested for erythromycin susceptibility, 121 (55.7%; ∼60% of coagulase-negative staphylococci and corynebacteria tested) showed resistance to erythromycin.
CONCLUSIONS: Microbial keratitis in the Baltimore Mid-Atlantic region of the United States is most commonly caused by bacteria, with fungi and acanthamoeba being less common. Gram-positive bacterial infections predominate. Among fungal keratitis cases, Candida species are more commonly encountered than are filamentous species. Use of erythromycin as infection prophylaxis should be reexamined. Findings from our study may guide empiric treatment in this geographic region.
METHODS: Retrospective review of culture-positive microbial keratitis cases at the Wilmer Eye Institute from 2016 through 2020.
RESULTS: Of the 474 culture-positive microbial keratitis cases, most were bacterial (N=450, 94.9%), followed by fungal (N=48, 10.1%) and Acanthamoeba keratitis (N=15, 3.1%). Of the 450 bacterial isolates, 284 (69.5%) were gram-positive organisms, whereas 157 (28.4%) were gram-negative organisms. The most common bacterial species isolated was coagulase-negative Staphylococcus spp (N=154, 24.8%), and the most common gram-negative isolate was Pseudomonas aeruginosa (N=76, 12.3%). Among fungi, the most common isolates were Candida (N=25, 45.4%), whereas Fusarium (N=6, 10.9%) and Aspergillus (N=3, 5.5%) were less common. Of the 217 bacterial isolates tested for erythromycin susceptibility, 121 (55.7%; ∼60% of coagulase-negative staphylococci and corynebacteria tested) showed resistance to erythromycin.
CONCLUSIONS: Microbial keratitis in the Baltimore Mid-Atlantic region of the United States is most commonly caused by bacteria, with fungi and acanthamoeba being less common. Gram-positive bacterial infections predominate. Among fungal keratitis cases, Candida species are more commonly encountered than are filamentous species. Use of erythromycin as infection prophylaxis should be reexamined. Findings from our study may guide empiric treatment in this geographic region.
摘要：
目的：在美国大西洋中部地区的一个大型三级转诊中心，研究培养阳性微生物性角膜炎的微生物分布和抗菌药物敏感性。
方法：回顾性回顾2016年至2020年Wilmer眼科研究所培养阳性微生物性角膜炎病例。
结果：在474例培养阳性的微生物性角膜炎病例中，大多数是细菌(N=450，94.9%)，其次是真菌（N=48，10.1％）和棘阿米巴角膜炎（N=15，3.1％）。在450个细菌分离物中，284（69.5%）为革兰氏阳性菌，而157（28.4％）是革兰氏阴性菌。最常见的细菌是凝固酶阴性葡萄球菌属（N=154，24.8%），最常见的革兰阴性分离株为铜绿假单胞菌(N=76,12.3%)。在真菌中,最常见的分离株是念珠菌（N=25，45.4%），镰刀菌（N=6，10.9％）和曲霉属（N=3，5.5％）较不常见。在217个细菌分离株的红霉素药敏试验中,121例（55.7%；60%的凝固酶阴性葡萄球菌和棒杆菌检测）对红霉素有耐药性。
结论：美国巴尔的摩中大西洋地区的微生物角膜炎最常见的是细菌，真菌和棘阿米巴不太常见。革兰氏阳性细菌感染占主导地位。在真菌性角膜炎病例中，念珠菌物种比丝状物种更常见。应重新检查使用红霉素作为预防感染的方法。我们的研究结果可能会指导该地理区域的经验性治疗。
方法：回顾性回顾2016年至2020年Wilmer眼科研究所培养阳性微生物性角膜炎病例。
结果：在474例培养阳性的微生物性角膜炎病例中，大多数是细菌(N=450，94.9%)，其次是真菌（N=48，10.1％）和棘阿米巴角膜炎（N=15，3.1％）。在450个细菌分离物中，284（69.5%）为革兰氏阳性菌，而157（28.4％）是革兰氏阴性菌。最常见的细菌是凝固酶阴性葡萄球菌属（N=154，24.8%），最常见的革兰阴性分离株为铜绿假单胞菌(N=76,12.3%)。在真菌中,最常见的分离株是念珠菌（N=25，45.4%），镰刀菌（N=6，10.9％）和曲霉属（N=3，5.5％）较不常见。在217个细菌分离株的红霉素药敏试验中,121例（55.7%；60%的凝固酶阴性葡萄球菌和棒杆菌检测）对红霉素有耐药性。
结论：美国巴尔的摩中大西洋地区的微生物角膜炎最常见的是细菌，真菌和棘阿米巴不太常见。革兰氏阳性细菌感染占主导地位。在真菌性角膜炎病例中，念珠菌物种比丝状物种更常见。应重新检查使用红霉素作为预防感染的方法。我们的研究结果可能会指导该地理区域的经验性治疗。
