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眼部对抗生素和多用途消毒溶液的敏感性。

Susceptibility of Ocular to Antibiotics and Multipurpose Disinfecting Solutions.

作者信息

Afzal Madeeha, Vijay Ajay Kumar, Stapleton Fiona, Willcox Mark D P

机构信息

School of Optometry and Vision Science, University of New South Wales, Sydney 2052, Australia.

出版信息

Antibiotics (Basel). 2021 Oct 3;10(10):1203. doi: 10.3390/antibiotics10101203.

Abstract

is a frequent cause of ocular surface infections worldwide. Of these surface infections, those involving the cornea (microbial keratitis) are most sight-threatening. can also cause conjunctivitis and contact lens-related non-infectious corneal infiltrative events (niCIE). The aim of this study was to determine the rates of resistance of isolates to antibiotics and disinfecting solutions from these different ocular surface conditions. In total, 63 strains from the USA and Australia were evaluated; 14 were from niCIE, 26 from conjunctivitis, and 23 from microbial keratitis (MK). The minimum inhibitory (MIC) and minimum bactericidal concentrations (MBC) of all the strains to ciprofloxacin, ceftazidime, oxacillin, gentamicin, vancomycin, chloramphenicol, azithromycin, and polymyxin B were determined. The MIC and MBC of the niCIE strains to contact lens multipurpose disinfectant solutions (MPDSs) was determined. All isolates were susceptible to vancomycin (100%). The susceptibility to other antibiotics decreased in the following order: gentamicin (98%), chloramphenicol (76%), oxacillin (74%), ciprofloxacin (46%), ceftazidime (11%), azithromycin (8%), and polymyxin B (8%). In total, 87% of all the isolates were multidrug resistant and 17% of the isolates from microbial keratitis were extensively drug resistant. The microbial keratitis strains from Australia were usually susceptible to ciprofloxacin (57% vs. 11%; = 0.04) and oxacillin (93% vs. 11%; = 0.02) compared to microbial keratitis isolates from the USA. Microbial keratitis isolates from the USA were less susceptible (55%) to chloramphenicol compared to conjunctivitis strains (95%; = 0.01). Similarly, 75% of conjunctivitis strains from Australia were susceptible to chloramphenicol compared to 14% of microbial keratitis strains ( = 0.04). Most (93%) strains isolated from contact lens wearers were killed in 100% MPDS, except 27. OPTI-FREE PureMoist was the most active MPDS against all strains with 35% of strains having an MIC ≤ 11.36%. There was a significant difference in susceptibility between OPTI-FREE PureMoist and Biotrue ( = 0.02). non-infectious CIE strains were more susceptible to antibiotics than conjunctivitis strains and conjunctivitis strains were more susceptible than microbial keratitis strains. Microbial keratitis strains from Australia (isolated between 2006 and 2018) were more susceptible to antibiotics in comparison with microbial keratitis strains from the USA (isolated in 2004). Most of the strains were multidrug-resistant. There was variability in the susceptibility of contact lens isolates to MPDSs with one strain, 27, isolated from niCIE, in Australia in 1997 being highly resistant to all four MPDSs and three different types of antibiotics. Knowledge of the rates of resistance to antibiotics in different conditions and regions could help guide treatment of these diseases.

摘要

在全球范围内是眼表感染的常见原因。在这些眼表感染中,累及角膜的感染(微生物性角膜炎)对视力威胁最大。 还可引起结膜炎以及与隐形眼镜相关的非感染性角膜浸润事件(niCIE)。本研究的目的是确定从这些不同眼表状况分离出的 菌株对抗生素和消毒溶液的耐药率。总共评估了来自美国和澳大利亚的63株 菌株;14株来自niCIE,26株来自结膜炎,23株来自微生物性角膜炎(MK)。测定了所有菌株对环丙沙星、头孢他啶、苯唑西林、庆大霉素、万古霉素、氯霉素、阿奇霉素和多粘菌素B的最低抑菌浓度(MIC)和最低杀菌浓度(MBC)。测定了niCIE菌株对隐形眼镜多功能消毒溶液(MPDSs)的MIC和MBC。所有分离株对万古霉素均敏感(100%)。对其他抗生素的敏感性按以下顺序降低:庆大霉素(98%)、氯霉素(76%)、苯唑西林(74%)、环丙沙星(46%)、头孢他啶(11%)、阿奇霉素(8%)和多粘菌素B(8%)。所有分离株中87%对多种药物耐药,微生物性角膜炎分离株中有17%对多种药物广泛耐药。与来自美国的微生物性角膜炎分离株相比,来自澳大利亚的微生物性角膜炎菌株通常对环丙沙星(57%对11%; = 0.04)和苯唑西林(93%对11%; = 0.02)敏感。与结膜炎菌株(95%; = 0.01)相比,来自美国的微生物性角膜炎分离株对氯霉素的敏感性较低(55%)。同样,与14%的微生物性角膜炎菌株相比,来自澳大利亚的75%的结膜炎菌株对氯霉素敏感( = 0.04)。从隐形眼镜佩戴者中分离出的大多数(93%)菌株在100%的MPDS中被杀死,但 27除外。OPTI-FREE PureMoist是对所有菌株最有效的MPDS,35%的菌株MIC≤11.36%。OPTI-FREE PureMoist和Biotrue之间的敏感性存在显著差异( = 0.02)。非感染性CIE菌株比结膜炎菌株对抗生素更敏感,结膜炎菌株比微生物性角膜炎菌株更敏感。与2004年分离的来自美国的微生物性角膜炎菌株相比,2006年至2018年期间分离的来自澳大利亚的微生物性角膜炎菌株对抗生素更敏感。大多数菌株对多种药物耐药。隐形眼镜分离株对MPDSs的敏感性存在差异,1997年在澳大利亚从niCIE中分离出的一株 菌株 27对所有四种MPDSs和三种不同类型的抗生素具有高度耐药性。了解不同状况和地区的抗生素耐药率有助于指导这些疾病的治疗。

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