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2020 OMIG Abstract

Antibiotic Resistance Among Bacterial Pathogens Isolated from the Cornea Over 11 Years of the ARMOR Surveillance Study

Penny A. Asbell, MD1, Christine M. Sanfilippo, PhD2, Heleen H. DeCory,PhD2
11Hamilton Eye Institute, University of Tennessee Health Science Center, Memphis, TN;
2Medical Affairs, Bausch + Lomb, Rochester, NY

Purpose: Antibiotic resistance may be problematic in bacterial infections of the cornea, impacting treatment success. Thus, understanding antibiotic resistance patterns gathered from surveillance studies may inform treatment choices. Here, we examine in vitro antibiotic resistance among presumed keratitis pathogens collected from 2009-2019 in ARMOR, the only nationwide surveillance study monitoring antibiotic resistance among ocular bacteria.

Methods: Clinically relevant corneal isolates of Staphylococcus aureus, coagulase-negative staphylococci (CoNS), Streptococcus pneumoniae, Pseudomonas aeruginosa, and Haemophilus influenzae; were obtained from centers across the US as part of ARMOR. Minimum inhibitory concentrations were determined at an independent central laboratory for up to 16 antibiotics (10 classes), and isolates were classified as susceptible or resistant per Clinical and Laboratory Standards Institute interpretive criteria, where available. Oxacillin was used to classify staphylococci as methicillin-resistant or methicillin-susceptible.

Results: A total of 1499 corneal pathogens (525 CoNS, 429 S. aureus, 385 P. aeruginosa, 127 S. pneumoniae, 33 H. influenza) were collected from 61 participating centers across 30 states. Staphylococci exhibited high resistance to azithromycin (54-56%), methicillin/oxacillin (35-42%), and ciprofloxacin (35-36%), with high rates of multidrug resistance (>3 classes; 34-41%), especially among methicillin-resistant strains (82-85%). While resistance was low among P. aeruginosa and H. influenza (<10%), S. pneumoniae were resistant to azithromycin (33%) and penicillin (30%).

Conclusion: Antibiotic resistance was prevalent among staphylococcal and pneumococcal isolates from the cornea. Since in vitro resistance may be predictive of treatment failure, these surveillance data are of relevance to practicing clinicians and should be considered when selecting appropriate antibacterial agents to treat keratitis infections.

Disclosure: C (PA Asbell); E (CM Sanfilippo, HH DeCory)

Support: Bausch Health US, LLC (ARMOR study sponsor)



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