Department of Ophthalmology, Training and Research Hospital, Bolu Abant Izzet Baysal University, Kılıçarslan Mah. 144. Sk No: 7/6 Merkez, Bolu, Turkey.
Department of Medical Microbiology, Training and Research Hospital, Bolu Abant Izzet Baysal University, Bolu, Turkey.
Int Ophthalmol. 2021 Apr;41(4):1395-1402. doi: 10.1007/s10792-021-01696-2. Epub 2021 Jan 27.
To evaluate the early efficacy and safety of intrastromal injection of teicoplanin as the alternative treatment for the methicillin-resistant Staphylococcus aureus (MRSA) keratitis by comparing it with vancomycin.
Twenty-four eyes of 24 New Zealand white rabbits were included in the study. MRSA keratitis was induced in the right eye of each rabbit by injecting 0.1 mL MRSA suspension containing 1000 colony-forming units (CFU) intrastromally to the central cornea. The rabbits were divided into three treatment groups 24 h after the inoculation of MRSA. Eight rabbits received intrastromal teicoplanin therapy, eight received intrastromal vancomycin therapy, and eight received balanced salt solution and served as the control group. Nine hours after the treatment, all rabbits were sacrificed and corneal tissues were collected for microbiological analysis. We also examined and scored all the rabbits clinically before and after the treatment.
The control group scored higher with regard to conjunctival injection, iritis, fibrin, hypopyon, epithelial erosion, and corneal infiltrate than the vancomycin and teicoplanin groups (p = 0.031, 0.010, < 0.001, 0.029, 0.009, and < 0.001, respectively). Chemosis and corneal oedema were similar in all groups (p = 0.731 and 0.075, respectively). The severity of all clinical parameters was similar in both the vancomycin and teicoplanin groups after the treatment. The bacterial load was the highest (7.83 ± 0.71 log CFU/g) in the control group. The eyes treated with vancomycin and teicoplanin had similar bacterial loads (6.40 ± 0.69 vs. 6.31 ± 0.75 log CFU/g, p = 0.809).
The efficiency of teicoplanin seems to be comparable to that of vancomycin when administered intrastromally in the early treatment of MRSA keratitis. The former may be preferred in the treatment of selected cases with vancomycin hypersensitivity or resistance.
通过与万古霉素比较，评估替考拉宁作为耐甲氧西林金黄色葡萄球菌（MRSA）角膜炎的替代治疗方案进行角膜内注射的早期疗效和安全性。
将 24 只新西兰白兔的 24 只眼纳入研究。通过向中央角膜内注射含有 1000 个菌落形成单位（CFU）的 0.1 mL MRSA 悬浮液，在每只兔子的右眼诱导 MRSA 角膜炎。在接种 MRSA 后 24 小时，将兔子分为三组进行治疗。八只兔子接受替考拉宁角膜内治疗，八只兔子接受万古霉素角膜内治疗，八只兔子接受平衡盐溶液治疗作为对照组。治疗后 9 小时，处死所有兔子并采集角膜组织进行微生物分析。我们还在治疗前后对所有兔子进行了临床检查和评分。
与万古霉素和替考拉宁组相比，对照组的结膜充血、虹膜炎、纤维蛋白、前房积脓、上皮糜烂和角膜浸润评分更高（p=0.031、0.010、<0.001、0.029、0.009 和<0.001）。所有组的球结膜水肿和角膜水肿相似（p=0.731 和 0.075）。治疗后，万古霉素和替考拉宁组的所有临床参数严重程度相似。对照组的细菌负荷最高（7.83±0.71 log CFU/g）。接受万古霉素和替考拉宁治疗的眼睛具有相似的细菌负荷（6.40±0.69 与 6.31±0.75 log CFU/g，p=0.809）。
替考拉宁似乎在 MRSA 角膜炎的早期治疗中与万古霉素一样有效。在万古霉素过敏或耐药的情况下，前者可能更适合治疗。
