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Stenotrophomonas maltophilia ocular infections
1Department of Ophthalmology, Baylor College of Medicine, Houston, Tex. USA.
Objectives:
To determine if the number of ocular infections associated with Stenotrophomonas maltophilia is increasing, to identify predisposing factors, and to evaluate antimicrobial susceptibility.
Methods:
Retrospective review of ocular microbiology laboratory records from January 1, 1972, through December 31, 1995.
Results:
Stenotrophomonas maltophilia was recovered from 15 cases of ocular infection, at a rate of one in every 1339 ocular specimens in the 1970s, one in 413 in the 1980s, and one in 363 in the 1990s through 1995. The organism was the predominant isolate in five cases and was part of a polybacterial infection in the remaining 10 cases. Eight of the 15 cases had bacterial keratitis, including one with infectious crystalline keratopathy. Of the remaining seven infections, S maltophilia was recovered from two cases of acute conjunctivitis, two infected scleral buckles (one with orbital cellulitis), two cases of infantile dacryocystitis, and one case of preseptal cellulitis. Ocular isolates of S maltophilia were resistant to the aminoglycosides and most beta-lactams, and showed variable susceptibility to the fluoroquinolones.
Conclusions:
Stenotrophomonas maltophilia is emerging as an important opportunistic ocular pathogen. Most infections by this organism occur in patients with ocular compromise, and the characteristically resistant antibiogram of S maltophilia limits the therapeutic options.
Insights
Stenotrophomonas maltophilia ocular infections are increasing, often in compromised eyes. This opportunistic pathogen shows resistance to common antibiotics, limiting treatment options.
Area of Science:
- Ophthalmology
- Microbiology
- Infectious Diseases
Background:
- Stenotrophomonas maltophilia is an opportunistic pathogen.
- Ocular infections caused by S. maltophilia have been reported.
- Predisposing factors and antimicrobial susceptibility patterns require investigation.
Purpose of the Study:
- To assess the trend of ocular infections caused by Stenotrophomonas maltophilia.
- To identify risk factors associated with S. maltophilia ocular infections.
- To evaluate the antimicrobial resistance profile of S. maltophilia ocular isolates.
Main Methods:
- Retrospective analysis of ocular microbiology laboratory records.
- Data collected from January 1, 1972, to December 31, 1995.
- Case identification and review of infection types and outcomes.
Main Results:
- S. maltophilia ocular infections increased significantly from the 1970s to the 1990s.
- Bacterial keratitis was the most common presentation, followed by conjunctivitis and infections related to medical devices.
- Ocular isolates demonstrated resistance to aminoglycosides and beta-lactams, with variable fluoroquinolone susceptibility.
Conclusions:
- Stenotrophomonas maltophilia is an emerging opportunistic pathogen in ocular infections.
- Patients with pre-existing ocular conditions are particularly susceptible.
- The observed antimicrobial resistance limits therapeutic choices for S. maltophilia eye infections.