Original articleAntibiotic Resistance in Microbial Keratitis: Ten-Year Experience of Corneal Scrapes in the United Kingdom
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Materials and Methods
The East Kent Hospitals University National Health Service Foundation Trust microbiology database was used to identify all corneal scrape samples undertaken from January 1, 1999 to December 31, 2008. Non-corneal samples, such as conjunctival swabs, were excluded. The database was then used to obtain basic patient demographic information and results of microscopy, culture, and subsequent antibiotic sensitivity and resistance testing. The Kent Research Ethics Committee approved the study.
All
Results
During the 10-year period, 476 corneal scrapes were undertaken in 440 patients. Female patients were investigated more than male patients (57.6% vs. 42.4%, P=0.001). The age of patients sampled showed a bimodal distribution, with peaks in the 31–40-year and 81–90-year age groups.
All samples were cultured. Culture was positive in 163 samples (34.2%), growing 172 organisms, with polymicrobial infection in 9 scrapes (5.5%). Bacterial keratitis accounted for 162 positive growths (94.2%), with 5
Discussion
This study has documented the highest levels of gram-negative keratitis in any known retrospective survey to date and highlights a trend of increasing gram-negative infection. We have demonstrated reducing chloramphenicol sensitivity, with high isolate sensitivity to combination gentamicin and cefuroxime, as well as ciprofloxacin. Gram-positive fluoroquinolone resistance was higher than previously reported in the United Kingdom, but showed no evidence of increasing resistance.
Soft contact lens
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Manuscript no. 2010-1152.
Aspects of data from this study were presented at: the Annual Congress of The Royal College of Ophthalmologists, May 20, 2009, Birmingham, United Kingdom.
Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.