Serratia keratitis transmitted by contaminated eyedroppers

Area of Science:

• Ophthalmology
• Microbiology

Background:

• Keratoplasty is a surgical procedure to restore vision.
• Ophthalmic solutions are commonly used post-surgery.

Observation:

• Three patients developed Serratia marcescens keratitis following keratoplasty.
• Two patients used prednisolone sodium phosphate eyedrops, and one used timolol maleate eyedrops.
• Serratia marcescens was found on eyedropper caps and bottletops, not in the solutions.

Findings:

• Moisture in the eyedrop bottle's dead space facilitated Serratia growth.
• Contaminated liquid on the eyedropper shaft inoculated patients' eyes during administration.
• All cases resolved with topical and subconjunctival antibiotic therapy.

Implications:

• Eyedrop bottle design can contribute to microbial contamination.
• Strict aseptic techniques are crucial for ophthalmic solution handling.
• Serratia marcescens poses a risk for post-keratoplasty infectious keratitis.