Park B-C, Lim Hwa-Rang, Park Seon-Joo, Koh Jae-Woong
Department of Ophthalmology, Chosun University College of Medicine, 365 Pilmun-daero, Dong-gu, Gwangju, Republic of Korea.
Department of Premedical Science, Chosun University College of Medicine, Gwangju, Republic of Korea.
Ophthalmol Ther. 2021 Sep;10(3):525-533. doi: 10.1007/s40123-021-00348-z. Epub 2021 May 13.
Stenotrophomonas maltophilia keratitis is an uncommon infectious disease of the cornea. The clinical features, antibiotic susceptibility, and clinical outcomes of S. maltophilia keratitis were investigated in this study.
Between January 2015 and February 2020, the medical records of 16 patients with culture-proven S. maltophilia-associated infectious keratitis were retrospectively reviewed. Clinical data were analyzed regarding risk factors, clinical presentation, antibiotic susceptibility, and clinical outcomes.
The average age of the patients was 56.24 ± 24.84 years. The most common risk factors for S. maltophilia keratitis were trauma (6/16, 37.5%), use of contact lenses (6/16, 37.5%), and herpes simplex virus keratitis (3/16, 18.8%), which caused ocular instability. Regarding the antibiotic sensitivities, most isolates (15/16, 93.8%) were susceptible to fluoroquinolones, 87.5% (14/16) of them to aminoglycosides, and 81.3% (13/16) of them to beta-lactams. Patients were classified into two groups according to the initial antibiotic eye drops, and there were significant differences in the final visual acuity between two groups: mixed fluoroquinolone, beta-lactam, aminoglycoside group, and mixed beta-lactam and aminoglycoside groups (p = 0.039).
Ocular infection due to S. maltophilia is an opportunistic infection followed by instability of the ocular surface. In cases of S. maltophilia infection, mixed use of fluoroquinolone, beta-lactam, and aminoglycoside should be considered for treatment of choice.
嗜麦芽窄食单胞菌角膜炎是一种罕见的角膜感染性疾病。本研究对嗜麦芽窄食单胞菌角膜炎的临床特征、抗生素敏感性及临床结局进行了调查。
回顾性分析2015年1月至2020年2月期间16例经培养证实的嗜麦芽窄食单胞菌相关性感染性角膜炎患者的病历。分析了危险因素、临床表现、抗生素敏感性及临床结局等临床资料。
患者的平均年龄为56.24±24.84岁。嗜麦芽窄食单胞菌角膜炎最常见的危险因素是外伤（6/16，37.5%）、使用隐形眼镜（6/16，37.5%）和单纯疱疹病毒性角膜炎（3/16，18.8%），这些因素导致眼表不稳定。关于抗生素敏感性，大多数分离株（15/16，93.8%）对氟喹诺酮类敏感，87.5%（14/16）对氨基糖苷类敏感，81.3%（13/16）对β-内酰胺类敏感。根据初始抗生素滴眼液将患者分为两组，两组最终视力存在显著差异：氟喹诺酮类、β-内酰胺类、氨基糖苷类混合组和β-内酰胺类与氨基糖苷类混合组（p = 0.039）。
嗜麦芽窄食单胞菌引起的眼部感染是一种机会性感染，随后出现眼表不稳定。对于嗜麦芽窄食单胞菌感染病例，应考虑联合使用氟喹诺酮类、β-内酰胺类和氨基糖苷类作为首选治疗方法。
