Department of Ophthalmology, University of Tennessee Health Science Center, Memphis, Tennessee.
Pharmaceutical Medical Affairs, Bausch + Lomb, Rochester, New York.
J Glob Antimicrob Resist. 2022 Jun;29:236-240. doi: 10.1016/j.jgar.2022.03.010. Epub 2022 Mar 23.
We evaluated antibiotic resistance among intraocular isolates obtained from presumed endophthalmitis cases collected from 2009 through 2020 in the Antibiotic Resistance Monitoring in Ocular micRoorganisms (ARMOR) study, the only ongoing nationwide surveillance study tracking in vitro resistance in ocular pathogens.
Presumed endophthalmitis isolates obtained from the aqueous humour and vitreous humour were collected from participating centres, and minimum inhibitory concentrations were determined and interpreted per Clinical and Laboratory Standards Institute methods and available breakpoints.
A total of 307 presumed endophthalmitis isolates (aqueous humour, n = 88; vitreous humour, n = 219) were obtained from 43 clinical sites, including 188 coagulase-negative staphylococci (CoNS), 61 Staphylococcus aureus, 31 Streptococcus pneumoniae, 14 Pseudomonas aeruginosa, and 13 Haemophilus influenzae isolates. Of the CoNS isolates, 47.9% (90/188) were methicillin resistant, 58.0% (109/188) were azithromycin resistant, and 46.3% (87/188) were ciprofloxacin resistant. Of the S. aureus isolates, 45.9% (28/61) were methicillin resistant, 57.4% (35/61) were azithromycin resistant, and 44.3% (27/61) were ciprofloxacin resistant. Multidrug resistance (MDR; i.e., resistance to ≥3 antibiotic classes) was prevalent among staphylococci, particularly methicillin-resistant strains, of which >70% exhibited MDR. Resistance among S. pneumoniae isolates was notable for azithromycin and penicillin, each 38.7% (12/31), and for polymyxin B among P. aeruginosa 100.0% (14/14), whereas no resistance was observed for H. influenzae isolates to the antibiotics tested.
In vitro antibiotic resistance was common among presumed endophthalmitis isolates collected in the ARMOR surveillance study. These data could inform antibiotic selection for infection prophylaxis and/or treatment of intraocular infections.
我们评估了 2009 年至 2020 年间在 ARMOR 研究中收集的疑似眼内炎病例的眼内分离株的抗生素耐药性，该研究是唯一一项持续进行的全国性监测研究，追踪眼部病原体的体外耐药性。
从参与中心收集疑似眼内炎的眼内分离物，包括房水和玻璃体液，并根据临床和实验室标准协会的方法和可用的折点确定最小抑菌浓度并进行解释。
共从 43 个临床中心获得 307 株疑似眼内炎分离物（房水，n=88；玻璃体液，n=219），包括 188 株凝固酶阴性葡萄球菌（CoNS）、61 株金黄色葡萄球菌、31 株肺炎链球菌、14 株铜绿假单胞菌和 13 株流感嗜血杆菌分离株。CoNS 分离株中，47.9%（90/188）为耐甲氧西林，58.0%（109/188）为耐阿奇霉素，46.3%（87/188）为耐环丙沙星。金黄色葡萄球菌分离株中，45.9%（28/61）为耐甲氧西林，57.4%（35/61）为耐阿奇霉素，44.3%（27/61）为耐环丙沙星。葡萄球菌，特别是耐甲氧西林的葡萄球菌，普遍存在多重耐药（MDR；即对≥3 类抗生素耐药），其中超过 70%的菌株表现出 MDR。肺炎链球菌分离株对阿奇霉素和青霉素的耐药率分别为 38.7%（12/31），对多粘菌素 B 的耐药率为 100.0%（14/14），而流感嗜血杆菌分离株对所测试的抗生素均无耐药性。
在 ARMOR 监测研究中收集的疑似眼内炎分离株中，体外抗生素耐药性很常见。这些数据可以为眼部感染的预防和/或治疗中抗生素的选择提供信息。
