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Recurrent microbial keratitis and endogenous site Staphylococcus aureus colonisation

Tobi F Somerville1,2, Jayendra Shankar3, Sarah Aldwinckle3

  • 1Department of Eye and Vision Sciences, University of Liverpool, 6 West Derby Street, Liverpool, L7 8TX, UK. tobi@liverpool.ac.uk.

Scientific Reports
|October 30, 2020
PubMed

Insights

Recurrent microbial keratitis (MK) is linked to higher Staphylococcus aureus carriage. Increased S. aureus in the eyes and nose suggests self-colonization may cause recurring MK infections.

Area of Science:

  • Ophthalmology
  • Microbiology
  • Infectious Diseases

Background:

  • Microbial keratitis (MK) is a serious eye infection.
  • Recurrent MK poses significant challenges in treatment and management.
  • Staphylococcus aureus is a common pathogen implicated in ocular infections.

Purpose of the Study:

  • To investigate Staphylococcus aureus (S. aureus) carriage in patients with microbial keratitis (MK).
  • To determine if S. aureus colonization in endogenous sites is associated with recurrent MK.
  • To compare S. aureus carriage rates between MK patients and control groups.

Main Methods:

  • Prospective study involving 215 MK patients, 60 healthy controls, and 35 rheumatoid arthritis patients.
  • Collection of corneal scrapes from MK patients and conjunctival, nasal, and throat swabs from all participants.
  • Microbiological culture techniques used for S. aureus isolation and identification.

Main Results:

  • Recurrent MK patients showed significantly higher S. aureus isolation rates from the cornea compared to single-episode MK patients (p<0.01).
  • Conjunctival S. aureus carriage was higher in recurrent MK patients (20.6%) than in controls (3%, p=0.01).
  • A higher proportion of recurrent MK patients (17.6%) had S. aureus in both conjunctiva and nose compared to single-episode MK (4.8%, p=0.002) and controls (5.0%, p=0.03).

Conclusions:

  • Patients with recurrent MK exhibit elevated rates of S. aureus carriage.
  • Endogenous colonization, particularly in the conjunctiva and nose, is a likely source for recurrent S. aureus MK infections.
  • Findings suggest screening for S. aureus carriage in endogenous sites for managing recurrent MK.

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