Antibiotic resistance of Pseudomonas aeruginosa from ocular samples in Canada: a 25-year analysis

IF 5.6 1区医学 Q1 OPHTHALMOLOGY

Ocular Surface Pub Date : 2025-07-30 DOI:10.1016/j.jtos.2025.07.011

Alfonso Iovieno , Barbara Burgos-Blasco , Derek Chan , Sean Ling , Simon Holland , Sonia N. Yeung

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引用次数: 0

Abstract

Objective

To identify trends in antibiotic resistance patterns of Pseudomonas aeruginosa (PA) over a multi-decade period and analyse clinical outcomes.

Methods

PA isolates from ocular samples were collected over a 25-year time period in British Columbia, Canada. Source and antibiotic resistance were recorded. Demographic data, previous ocular history and clinical outcomes of patients with PA keratitis were analysed and compared in moxifloxacin-resistant versus moxifloxacin-sensitive PA keratitis cases.

Results

321 ocular isolates of Pseudomonas were identified, 297 (92.5 %) of which were PA (101, 34 % cornea samples). Resistance to chloramphenicol was 88.7 %, 23.7 % to moxifloxacin and 10.1 % to meropenem. An increase in moxifloxacin resistance and non-susceptibility was noted, with a decrease in tobramycin resistance. The same trend was not observed for other fluroquinolone antibiotics. 14 (4.7 %) PA isolates were multi drug-resistant. 53 PA corneal isolates were included in the clinical analysis: 21 (40 %) sensitive, 17 (32 %) intermediate and 15 (28 %) resistant to moxifloxacin. Non-susceptible PA patients were older, more frequently non-contact lens wearers and a had a higher prevalence of previous ocular surgeries and topical treatment. A lower clinical response to initial treatment was observed in resistant cases. Need for surgery and complications were higher among moxifloxacin-resistant cases.

Conclusions

This study reports for the first time in North America a progressive and significant increase in moxifloxacin resistance among PA isolates. Overuse of topical moxifloxacin may be underlying this finding. Given the worse clinical outcomes in resistant cases, we would caution against the use of moxifloxacin alone as empirical treatment of infectious keratitis.

查看原文本刊更多论文

加拿大眼部样本中铜绿假单胞菌的抗生素耐药性：25年分析。

目的：确定铜绿假单胞菌（PA）耐药性模式的趋势，并分析其临床结果。方法：从加拿大不列颠哥伦比亚省的眼部样本中收集了25年的PA分离物。记录来源及抗生素耐药性。分析并比较莫西沙星耐药和莫西沙星敏感的PA角膜炎患者的人口统计学资料、既往眼部病史和临床结果。结果：共检出321株假单胞菌，其中PA 297株（92.5%），占角膜标本的101.34%。氯霉素耐药率为88.7%，莫西沙星耐药率为23.7%，美罗培南耐药率为10.1%。莫西沙星耐药和非敏感性增加，妥布霉素耐药减少。其他氟喹诺酮类抗生素没有观察到同样的趋势。14株（4.7%）PA分离株多重耐药。临床分析53株PA角膜分离株：对莫西沙星敏感21株（40%），中间17株（32%），耐药15株（28%）。非易感PA患者年龄较大，经常佩戴非隐形眼镜，既往眼部手术和局部治疗的患病率较高。耐药病例对初始治疗的临床反应较低。莫西沙星耐药病例的手术需求和并发症较高。结论：本研究首次在北美报道了PA分离株中莫西沙星耐药性的进展性和显著性增加。过量使用局部莫西沙星可能是这一发现的基础。鉴于耐药病例的临床结果较差，我们建议不要单独使用莫西沙星作为感染性角膜炎的经验性治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Ocular Surface 医学-眼科学

CiteScore

11.60

自引率

14.10%

发文量

审稿时长

39 days

期刊介绍： The Ocular Surface, a quarterly, a peer-reviewed journal, is an authoritative resource that integrates and interprets major findings in diverse fields related to the ocular surface, including ophthalmology, optometry, genetics, molecular biology, pharmacology, immunology, infectious disease, and epidemiology. Its critical review articles cover the most current knowledge on medical and surgical management of ocular surface pathology, new understandings of ocular surface physiology, the meaning of recent discoveries on how the ocular surface responds to injury and disease, and updates on drug and device development. The journal also publishes select original research reports and articles describing cutting-edge techniques and technology in the field. Benefits to authors We also provide many author benefits, such as free PDFs, a liberal copyright policy, special discounts on Elsevier publications and much more. Please click here for more information on our author services. Please see our Guide for Authors for information on article submission. If you require any further information or help, please visit our Support Center