Título

MICROBIAL PROFILE IN INFECTIOUS KERATITIS OVER 5 YEARS IN A TERTIARY CARE CENTER, BRAZIL: PATHOGENS AND ITS RESISTANCE

Objetivo

Infectious keratitis remains a sight-threatening disease and its prompt diagnosis, agent detection and early treatment are imperative. The aim of this study was to investigate the etiology and antimicrobial patterns of isolates in scrapes of corneal ulcers in patients referred to the Hospital das Clinicas, School of Medicine, University of Sao Paulo, in a 5-year period.

Método

A retrospective analysis of corneal scrapes of patients diagnosed with microbial keratitis was performed from January 2013 to December 2017. All microbiological examinations were conducted at the Department of Microbiology of Hospital das Clinicas, Brazil. Demographics, microbiological data, antibiotic resistance and sensitivity were collected.

Resultado

A total of 318 corneal scrapes were performed on eyes of 307 patients, 109 female (35.5%) and 198 male (64.5%), mean age 50.7 years (range 1 to 90). A total of 201 organisms were isolated from 168 (52.8%) positive samples. Infections due to a single organism occurred in 140 (83.3%) of the samples, and more than one agent were found in 28 (16.7%). Bacterial isolates represented 86.1%: 51.2% were gram-positive and 34.8% gram-negative. Cutibacterium acnes (10.9%) and Pseudomonas aeruginosa (10.4%) were the most common bacteria detected. Fungal keratitis represented 13.9% of the total positive cultures; Candida spp (23%) and Fusarium sp (7%) were the main fungi isolated. All gram-positive tested were sensitive to vancomycin and 98% of the gram-negative were sensitive to ceftazidime. All Pseudomonas aeruginosa isolates were sensitive to gentamicin and ciprofloxacin. Ciprofloxacin and gentamicin-resistance was higher in gram-positive than in gram-negative.

Conclusão

Our study revealed a predominance of Gram-positive bacteria in keratitis isolates. Our results suggest that in case of severe bacterial keratitis in our area, vancomycin should be considered as empirical treatment. In case of Pseudomonas keratitis, gentamicin is still a good option.