Inoue Hidenori, Suzuki Takashi, Inoue Tomoyuki, Hattori Takaaki, Nejima Ryohei, Todokoro Daisuke, Hoshi Saichi, Eguchi Hiroshi, Miyamoto Hitoshi, Ohashi Yuichi
*OMIC (Ocular Microbiology and Infection Conference) Working Group; †Department of Ophthalmology, Ehime University Graduate School of Medicine, Toon, Japan; ‡Department of Ophthalmology, Tokyo Medical University, Tokyo, Japan; §Miyata Eye Hospital, Miyakonojo, Japan; ¶Department of Ophthalmology, Gunma University School of Medicine, Maebashi, Japan; ‖Department of Ophthalmology, National Center for Geriatrics and Gerontology, Obu, Japan; **Department of Ophthalmology, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan; and ††Department of Clinical Laboratory, Ehime University Hospital, Toon, Japan.
Cornea. 2015 Sep;34(9):1105-9. doi: 10.1097/ICO.0000000000000470.
Moraxella species are rare causative pathogens of severe sight-threatening keratitis. The aim of this study was to analyze the clinical presentation, predisposing risk factors, in vitro antimicrobial susceptibility, and treatment associated with Moraxella keratitis.
We retrospectively reviewed 30 culture-proven cases of Moraxella keratitis from multiple centers in Japan.
The mean age of the patients was 58.4 ± 23.4 years. The most common ocular conditions were contact lens wearing (5 patients, 16.7%) and trauma (3 patients, 10.0%). Seven patients had diabetes mellitus. Sixteen patients exhibited hypopyon in association with the corneal focus. Ring-shaped infiltration was found in 9 patients (30.0%), and irregular or amoebic-shaped infiltration was observed in 13 patients (43.3%). Eight patients (26.7%) showed small round infiltrates. All Moraxella isolates were sensitive to fluoroquinolones and aminoglycosides. All were treated with a combination ophthalmic solution containing a fluoroquinolone, tobramycin, and cefmenoxime. Although no patients developed corneal perforation, the response to treatment was slow in all cases; the mean treatment period was 41.9 days.
In Japan, Moraxella keratitis occurs in patients with contact lens wear, trauma, and diabetes mellitus. It presents as a small, round, ring-shaped, irregularly shaped, or amoebic-shaped focus. Moraxella species exhibit good susceptibility to fluoroquinolones and aminoglycosides. Because the treatment response may be very slow, these agents should be continued for a long period of time.
莫拉克斯氏菌属是严重威胁视力的角膜炎的罕见致病病原体。本研究的目的是分析莫拉克斯氏菌角膜炎的临床表现、易感危险因素、体外抗菌药敏性及相关治疗。
我们回顾性分析了日本多个中心30例经培养证实的莫拉克斯氏菌角膜炎病例。
患者的平均年龄为58.4±23.4岁。最常见的眼部情况是佩戴隐形眼镜（5例，16.7%）和外伤（3例，10.0%）。7例患者患有糖尿病。16例患者角膜病灶伴有前房积脓。9例患者（30.0%）出现环形浸润，13例患者（43.3%）观察到不规则或阿米巴样浸润。8例患者（26.7%）表现为小圆形浸润。所有莫拉克斯氏菌分离株对氟喹诺酮类和氨基糖苷类敏感。所有患者均接受含氟喹诺酮、妥布霉素和头孢甲肟的联合滴眼液治疗。虽然没有患者发生角膜穿孔，但所有病例对治疗的反应都很缓慢；平均治疗期为41.9天。
在日本，莫拉克斯氏菌角膜炎发生于佩戴隐形眼镜、有外伤史和糖尿病的患者。其表现为小圆形、环形、不规则形或阿米巴样病灶。莫拉克斯氏菌属对氟喹诺酮类和氨基糖苷类表现出良好的敏感性。由于治疗反应可能非常缓慢，这些药物应长期持续使用。
