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2014 Agenda and Abstracts | < Previous | Next >

2014 OMIG Abstract 4

Extensively Drug Resistant Pseudomonas aeruginosa Keratitis:
Clinical Features, Risk Factors, and Outcome

Merle Fernandes, MS1; M Radhika, MS1; Divya Vira, MS1; Nagendra Kumar, MSc2
1Cornea and Anterior Segment Service, LV Prasad Eye Institute, Visakhapatnam, AP, India

2Microbiology Department, LV Prasad Eye Institute, Visakhapatnam, AP, India

Purpose: To describe the clinical features, risk factors and outcome of 15 cases of extensively drug resistant (XDR) Pseudomonas aeruginosa keratitis.

Methods: We performed a retrospective analysis of 15 cases of culture proven Pseudomonas aeruginosa keratitis. The following data was collected: age, gender, occupation, duration of symptoms, systemic and ocular risk factors, location and size of infiltrate, associated thinning or perforation, antimicrobial susceptibility, complications during the course of treatment, surgical interventions, presenting and final visual acuity and final outcome. Extensively drug resistant Pseudomonas aeruginosa keratitis was defined based upon criteria established by the Centres for Disease Control and Prevention and European Centre for Disease Prevention and Control.

Results: There were 15 eyes of 13 patients with XDR Pseudomonas aeruginosa keratitis. Seven (53.8 %) were male with left eye involvement in 9(60 %) cases. The mean duration of symptoms was 4.86±2.32 days. Except for 1 patient, risk factors were noted in all. The most common was the use of a bandage contact lens in 6(40%) eyes, previous therapeutic graft in 4(26.6 %) eyes, topical steroids in 5(33.3 %) eyes and ocular surface disorder following Stevens Johnson syndrome in 4(26.6%) eyes. Of the 15 isolates, 6(40%) were sensitive only to Imipenem, 3(20 %) were sensitive to Colistin, 2(13.3 %) were sensitive to Azithromycin & Tetracycline, 1(6.6%) each were sensitive to Imipenem & Colistin, Imipenem & Ceftazidime and Azithromycin respectively. One isolate was resistant to all groups of antibiotics tested. At the final follow up, 5(33.3%) had healed on topical medication. Eight (53.3 %) therapeutic grafts were done of which one was clear and the remaining failed.

Conclusion: Extensively drug resistant Pseudomonas aeruginosa keratitis is an emerging challenging problem. Predisposing risk factors were identified in almost all patients thus close monitoring of those with known ocular or systemic risk factors is warranted.

Disclosure: N

2014 Agenda and Abstracts | < Previous | Next >