Department of Internal Medicine, University Hospital of Heraklion, Heraklion, Crete, Greece.
Department of Clinical Microbiology and Microbial Pathogenesis, University Hospital of Heraklion, Heraklion, Crete, Greece.
Cont Lens Anterior Eye. 2021 Aug;44(4):101355. doi: 10.1016/j.clae.2020.07.006. Epub 2020 Aug 8.
To evaluate the bacterial spectrum and antimicrobial susceptibilities of pathogens isolated from contact lens-related bacterial keratitis cases in a large academic Greek hospital.
All adult patients with positive corneal scrapings or contact lens culture between 2007 and 2016 at the University Hospital of Heraklion, Greece, were retrospectively identified through a local microbiology database and their medical records were reviewed.
A total of 240 isolates were recovered from 131 patients with culture-proven contact lens-associated bacterial keratitis. The most common microorganism identified was Serratia marcescens (17.1% of total isolates), followed by Pseudomonas aeruginosa, Klebsiella spp. and coagulase-negative staphylococci (CoNS). Rates of aztreonam-resistant P. aeruginosa and erythromycin-resistant CoNS decreased in recent years, while the decrease in oxacillin-resistant CoNS was statistically significant (p=0.009). More than 90% of the isolated organisms (S. marcescens, P. aeruginosa, Klebsiella spp. and CoNS) were susceptible to ciprofloxacin or gentamicin.
Gram-negative microorganisms are the most common causative pathogens of contact lens-related keratitis in the region of Crete. Topical antibacterials containing quinolones or gentamicin represent an effective empirical treatment for the majority of the cases. This is quite encouraging, considering that the present study was conducted in a country characterised by high antimicrobial resistance rates. However, culture-driven antimicrobial treatment is mandatory for this sight-threatening infection.
评估希腊一家大型学术医院中与接触镜相关的细菌性角膜炎病例中分离出的病原体的细菌谱和药敏情况。
通过当地微生物数据库回顾性确定 2007 年至 2016 年间在希腊伊拉克利翁大学医院就诊的所有阳性角膜刮片或接触镜培养的成年患者，并查阅其病历。
从 131 例培养证实与接触镜相关的细菌性角膜炎患者中分离出 240 株培养物。最常见的微生物是粘质沙雷氏菌（占总分离株的 17.1%），其次是铜绿假单胞菌、克雷伯菌属和凝固酶阴性葡萄球菌（CoNS）。近年来，耐氨曲南的铜绿假单胞菌和耐红霉素的 CoNS 的发生率有所下降，而耐苯唑西林的 CoNS 则呈显著下降趋势（p=0.009）。超过 90%的分离菌（粘质沙雷氏菌、铜绿假单胞菌、克雷伯菌属和 CoNS）对环丙沙星或庆大霉素敏感。
革兰氏阴性微生物是克里特岛地区与接触镜相关角膜炎的最常见病原体。含喹诺酮类或庆大霉素的局部抗菌药物是大多数病例的有效经验性治疗方法。考虑到本研究是在一个具有高抗菌药物耐药率的国家进行的，这是相当令人鼓舞的。然而，对于这种威胁视力的感染，必须进行培养驱动的抗菌治疗。
