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Long-term Infectious Keratitis Microbiology and Resistance Patterns With Forecasts to 2030: A 23-Year Analysis
Guillermo Raul Vera-Duarte1, Luis Haro-Morlett, Thelma Cortés-Moreno
1Instituto de Oftalmologia Fundacion Conde de Valenciana IAP, Mexico City, Mexico.
Cornea
|July 24, 2026
Summary
Infectious keratitis trends show a late-2000s shift followed by stabilization. Forecasts to 2030 predict continued stability with specific antibiotic resistance concerns for Gram-positive and Gram-negative bacteria.
Area of Science:
- Ophthalmology
- Microbiology
- Infectious Diseases
Background:
- Infectious keratitis (IK) poses a significant threat to vision.
- Understanding trends in causative microorganisms and antibiotic resistance is crucial for effective treatment.
Purpose of the Study:
- To analyze 23-year trends in IK microbiology and antibiotic resistance in Mexico City.
- To forecast these trends through 2030 to guide empiric therapy and antimicrobial stewardship.
Main Methods:
- Analysis of 4748 corneal scrapings from 2002-2024.
- Statistical methods including Chow tests for structural breaks and time series models (ARIMA, ETS, OLS) for trend analysis and forecasting.
- Susceptibility testing interpreted per CLSI guidelines.
Main Results:
- Bacterial isolates (89.92%) predominated over fungi (10.08%).
- Key organisms included Staphylococcus epidermidis, Pseudomonas aeruginosa, and Staphylococcus aureus; Fusarium was the main fungus.
- Gram-positive resistance increased for fluoroquinolones and vancomycin, while Gram-negative resistance rose for cephalosporins and carbapenems.
Conclusions:
- IK microbiology experienced a significant shift in the late 2000s, followed by stabilization.
- Forecasts suggest continued stability with emerging resistance concerns, emphasizing the need for ongoing surveillance and stewardship.
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