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一名隐形眼镜佩戴者患耶氏副球菌性角膜炎。

Paracoccus yeei keratitis in a contact lens wearer.

作者信息

Courjaret Jean-Christophe, Drancourt Michel, Hoffart Louis

机构信息

Department of Opthalmology (J.C., L.H.), Timone Hospital, Assistance Publique-Hôpitaux de Marseille, Marseille, France; and Aix Marseille Université (M.D.), URMITE, UMR CNRS 7278, IRD 198, INSERM 1095, Marseille, France.

出版信息

Eye Contact Lens. 2014 May;40(3):e21-2. doi: 10.1097/ICL.0b013e31829e8fc7.

Abstract

OBJECTIVES

Paracoccus yeei is an environmental bacterium suspected to be responsible for ocular infections. In this study, culture-based and polymerase chain reaction (PCR) sequencing-based investigations of a corneal scraping specimen confirmed P. yeei keratitis in one contact lens wearer.

METHODS

A 34-year-old male patient, who was a contact lens wearer, presented with a unilateral corneal ulcer. A corneal scraping was performed to conduct a microbiological investigation. Disease progress was favorable after a 5-week topical treatment, which combined rifampicin, ciprofloxacine, tobramycine, and dexamethasone. The final visual acuity of the right eye was 5/10 with correction, limited by a central corneal scar.

RESULTS

Culturing the corneal scraping specimen yielded P. yeei, which was also directly detected by PCR sequencing the bacterial 16S rDNA in the presence of negative controls. The P. yeei isolate was susceptible to ticarcillin, with a minimal inhibitory concentration (MIC) of <4 mg/L of ceftazidime (MIC of 0.5 mg/L), imipenem (MIC < 0.5 mg/L), gentamycin (MIC of 0.5 mg/L), tobramycin (MIC < 0.06 mg/L), rifampicin (MIC < 0.125 mg/L), ciprofloxacin (MIC < 0.5 mg/L), and colimycin (MIC < 2 mg/L). The isolate was resistant to fosfomycine with a MIC 32 > mg/L.

CONCLUSIONS

P. yeei is a new cause of keratitis that must be diagnosed by a laboratory analysis of corneal scrapings due to the potentially poor outcome of infection.

摘要

目的

叶氏副球菌是一种环境细菌,被怀疑与眼部感染有关。在本研究中,通过对一份角膜刮片标本进行基于培养和聚合酶链反应(PCR)测序的调查,确诊一名隐形眼镜佩戴者患有叶氏副球菌性角膜炎。

方法

一名34岁男性隐形眼镜佩戴者出现单侧角膜溃疡。进行角膜刮片以开展微生物学调查。经5周联合使用利福平、环丙沙星、妥布霉素和地塞米松的局部治疗后,病情进展良好。右眼最终矫正视力为5/10,受中央角膜瘢痕限制。

结果

角膜刮片标本培养出叶氏副球菌,在有阴性对照的情况下,通过对细菌16S rDNA进行PCR测序也直接检测到了该菌。分离出的叶氏副球菌对替卡西林敏感,对头孢他啶的最低抑菌浓度(MIC)<4 mg/L(MIC为0.5 mg/L)、亚胺培南(MIC<0.5 mg/L)、庆大霉素(MIC为0.5 mg/L)、妥布霉素(MIC<0.06 mg/L)、利福平(MIC<0.125 mg/L)、环丙沙星(MIC<0.5 mg/L)和黏菌素(MIC<2 mg/L)敏感。该分离株对磷霉素耐药,MIC>32 mg/L。

结论

叶氏副球菌是角膜炎的一种新病因,由于感染可能导致不良后果,必须通过对角膜刮片进行实验室分析来诊断。

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