Journal article
Boston Type I Keratoprosthesis: Antibacterial Resistance and Microbiota Evaluation of Soft Contact Lenses.
- Torres-Netto EA Department of Ophthalmology and Visual Sciences, Paulista School of Medicine, Federal University of Sao Paulo (EPM-UNIFESP), Sao Paulo, Brazil; Ocular Cell Biology Group, Center for Applied Biotechnology and Molecular Medicine, University of Zurich (UZH), Zurich, Switzerland. Electronic address: emilioatorres@me.com.
- Silva LD Department of Ophthalmology and Visual Sciences, Paulista School of Medicine, Federal University of Sao Paulo (EPM-UNIFESP), Sao Paulo, Brazil.
- Bordon Riveros MA Department of Ophthalmology and Visual Sciences, Paulista School of Medicine, Federal University of Sao Paulo (EPM-UNIFESP), Sao Paulo, Brazil.
- Santos A Department of Ophthalmology and Visual Sciences, Paulista School of Medicine, Federal University of Sao Paulo (EPM-UNIFESP), Sao Paulo, Brazil.
- Sousa LB Department of Ophthalmology and Visual Sciences, Paulista School of Medicine, Federal University of Sao Paulo (EPM-UNIFESP), Sao Paulo, Brazil.
- Oliveira LA Department of Ophthalmology and Visual Sciences, Paulista School of Medicine, Federal University of Sao Paulo (EPM-UNIFESP), Sao Paulo, Brazil.
- 2018-06-02
Published in:
- American journal of ophthalmology. - 2018
Aged
Anti-Bacterial Agents
Artificial Organs
Bacteria
Contact Lenses, Hydrophilic
Cornea
Drug Resistance, Bacterial
Female
Follow-Up Studies
Humans
Male
Microbial Sensitivity Tests
Microbiota
Middle Aged
Moxifloxacin
Postoperative Period
Prospective Studies
Prostheses and Implants
English
PURPOSE
To evaluate microbiota colonizing soft contact lenses (CL) in eyes with Boston type I keratoprosthesis (BKPro), and determine the prevalence of resistance to fourth-generation fluoroquinolone (FQ).
DESIGN
Prospective, observational study.
SUBJECTS
Patients with BKPro using CL as routine who were in postoperative follow-up in the Department of Ophthalmology of the Federal University of Sao Paulo, and volunteered to participate in the study. All patients were under a prophylactic scheme of topical 0.5% moxifloxacin 3 times a day and topical 5% povidone-iodine (PI) at the time of CL exchange.
METHODS
Patients on scheduled replacement scheme of CL had their lenses removed and sent for microbiological analysis. Standard culture methods were used for microorganism identification and susceptibility to different antibiotics was tested. Main outcome measure was prevalence of resistance to fourth-generation FQ.
RESULTS
Among the 19 eyes, 12 eyes (63%) had at least 1 positive bacterial culture. The most prevalent isolates were Staphylococcus epidermidis and other coagulase-negative staphylococci. Actinomyces viscosus was isolated in 1 CL. Fungal cultures were all negative. Of the 12 eyes with culture bacterial growth, resistance to fourth-generation FQ (0.5% moxifloxacin) was identified in 6 different eyes (50%). None presented infectious complications.
CONCLUSIONS
FQ-resistant bacteria were isolated in some patients. Although our prophylactic antibiotic regimen has been efficient in preventing bacterial infection, this analysis demonstrated that prophylaxis with PI and low FQ dose might increase resistance to antibiotics. Investigations in this field may help to outline future changes of prophylactic guidelines and therapeutic strategies.
To evaluate microbiota colonizing soft contact lenses (CL) in eyes with Boston type I keratoprosthesis (BKPro), and determine the prevalence of resistance to fourth-generation fluoroquinolone (FQ).
DESIGN
Prospective, observational study.
SUBJECTS
Patients with BKPro using CL as routine who were in postoperative follow-up in the Department of Ophthalmology of the Federal University of Sao Paulo, and volunteered to participate in the study. All patients were under a prophylactic scheme of topical 0.5% moxifloxacin 3 times a day and topical 5% povidone-iodine (PI) at the time of CL exchange.
METHODS
Patients on scheduled replacement scheme of CL had their lenses removed and sent for microbiological analysis. Standard culture methods were used for microorganism identification and susceptibility to different antibiotics was tested. Main outcome measure was prevalence of resistance to fourth-generation FQ.
RESULTS
Among the 19 eyes, 12 eyes (63%) had at least 1 positive bacterial culture. The most prevalent isolates were Staphylococcus epidermidis and other coagulase-negative staphylococci. Actinomyces viscosus was isolated in 1 CL. Fungal cultures were all negative. Of the 12 eyes with culture bacterial growth, resistance to fourth-generation FQ (0.5% moxifloxacin) was identified in 6 different eyes (50%). None presented infectious complications.
CONCLUSIONS
FQ-resistant bacteria were isolated in some patients. Although our prophylactic antibiotic regimen has been efficient in preventing bacterial infection, this analysis demonstrated that prophylaxis with PI and low FQ dose might increase resistance to antibiotics. Investigations in this field may help to outline future changes of prophylactic guidelines and therapeutic strategies.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1016/j.ajo.2018.05.021
- PMID 29856980
- Persistent URL
- https://sonar.ch/global/documents/47542
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