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2007 OMIG, Abstract 4

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Change in the Incidence of Non-Tuberculous Mycobacteria Related Keratitis in the Fourth Generation Flouroquinolone Era.
Jayrag Patel, Mahendra K. Shah, David C. Ritterband, Carolyn Shih, John A. Seedor, Richard S. Koplin.
Departments of Ophthalmology and Laboratory Medicine, The New York Eye and Ear Infirmary, New York, NY and New York Medical College, Valhalla, NY

Purpose: To study the incidence of Non-Tuberculous Mycobacteria (NTM) related keratitis, since the introduction of the fourth generation fluoroquinolone antibiotics in 2003.
Methods: Due to a reported increased incidence of NTM causing subacute or late infectious keratitis following laser in situ keratomileusis (LASIK), beginning in 1998, the medical records of all cases of infectious keratitis submitted to the microbiologic laboratory of the New York Eye and Ear Infirmary (NYEEI) between January 1, 2000 and July 31, 2007 were reviewed. All cases in which NTM were recovered from cornea cultures were recorded. The data was divided into two groups based on the dates obtained, between 2000 - 2003 and 2004 - present and whether they were acquired following LASIK.
Results: 13 positive cultures for NTM related infectious keratitis were obtained out of 1871 total cultures at the NYEEI microbiology laboratory from January 1, 2000 through December 31, 2003. No cases of NTM were recorded from January 1 2004- through to July 31, 2007 in 2528 total cultures taken at the NYEEI microbiology laboratory. Of the 13 cases at NYEEI, 7 were following LASIK surgery.
Conclusions: The decreased incidence of NTM related keratitis following LASIK from 2004 to present may be partly related to increased awareness, avoiding ice/water on the sterile field, improved sterilization practices, the use of disposable equipment, and an increase in the number of surface ablation procedures. However, it parallels the introduction of the fourth generation fluoroquinolones to the marketplace in 2003 and may also help explain the decrease of NTM keratitis in non-LASIK eyes. These findings were corroborated by the Campbell Laboratory at the University of Pittsburgh Medical Center who had 2 positive NTM cases between Jan 1, 2000 to December 31, 2003, both from patients with non-LASIK infectious keratitis and no cases from 2004 to present (personal communication with R. Kowalski).

Disclosure code: N

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