Multidrug-resistant keratitis: challenging yet manageable.

Area of Science:

• Ophthalmology
• Infectious Diseases
• Microbiology

Background:

• Bacterial keratitis poses a significant threat to vision.
• The rise of multidrug-resistant (MDR) organisms complicates treatment and necessitates understanding of resistance patterns.

Purpose of the Study:

• To investigate the incidence, clinical characteristics, and treatment outcomes of bacterial keratitis caused by multidrug-resistant pathogens.
• To analyze risk factors, clinical presentation, and microbial resistance profiles in MDR bacterial keratitis.

Main Methods:

• Retrospective analysis of all MDR bacterial keratitis cases over two years.
• Collection of data on risk factors, infiltrate characteristics, treatment regimens, and patient outcomes.
• Antibiotic susceptibility testing of ocular isolates to determine resistance patterns.

Main Results:

• Forty cases of MDR bacterial keratitis were identified, with vegetative trauma and corneal transplantation as common risk factors.
• Gram-negative bacilli, particularly Pseudomonas aeruginosa, were the most frequent isolates.
• High levels of antibiotic resistance were observed, with many isolates resistant to multiple drug classes.
• Complete resolution with medical management alone occurred in 37.5% of patients; infiltrate size correlated significantly with outcome (p=0.002).

Conclusions:

• MDR bacterial keratitis presents a significant clinical challenge.
• Successful management is achievable with timely and appropriate medical therapy, even in cases of severe infection.
• Early intervention is crucial for improving outcomes in patients with MDR bacterial keratitis.