Atypical mycobacteria keratitis after laser in situ keratomileusis unresponsive to fourth-generation fluoroquinolone therapy

Cruz, José de la; Behlau, Irmgard; Pineda, Roberto

doi:10.1016/j.jcrs.2007.03.035

Cited by 22 publications

(6 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Examples of organisms wrongly determined to have caused the infection are Nocardia species [ 35 , 36 , 70 , 71 , 128 , 177 ] as well as Corynebacterium species [ 74 ]. Some examples of the incorrect diagnoses made were herpes keratitis [ 46 , 50 , 53 , 55 , 66 ] and fungal keratitis [ 39 , 46 , 48 , 54 , 94 ]. An orbital infection was confused for pseudotumor [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

Nontuberculous Mycobacterial Ocular Infections: A Systematic Review of the Literature

Kheir

Sheheitli

Fattah

et al. 2015

BioMed Research International

View full text Add to dashboard Cite

Nontuberculous or atypical mycobacterial ocular infections have been increasing in prevalence over the past few decades. They are known to cause periocular, adnexal, ocular surface and intraocular infections and are often recalcitrant to medical therapy. These infections can potentially cause detrimental outcomes, in part due to a delay in diagnosis. We review 174 case reports and series on nontuberculous mycobacterial (NTM) ocular infections and discuss etiology, microbiology, risk factors, diagnosis, clinical presentation, and treatment of these infections. History of interventions, trauma, foreign bodies, implants, contact lenses, and steroids are linked to NTM ocular infections. Steroid use may prolong the duration of the infection and cause poorer visual outcomes. Early diagnosis and initiation of treatment with multiple antibiotics are necessary to achieve the best visual outcome.

show abstract

Section: Discussionmentioning

confidence: 99%

Nontuberculous Mycobacterial Ocular Infections: A Systematic Review of the Literature

Kheir

Sheheitli

Fattah

et al. 2015

BioMed Research International

View full text Add to dashboard Cite

show abstract

“…Recent studies have suggested that the fluoroquinolones are useful for treating NTM infections ( 63 ). Reports on NTM resistance to ciprofloxacin and gatifloxacin have been published ( 64 – 66 ).…”

Section: Discussionmentioning

confidence: 99%

Biofilms of Pathogenic Nontuberculous Mycobacteria Targeted by New Therapeutic Approaches

Aung

Yam

Lin

et al. 2016

Antimicrob Agents Chemother

View full text Add to dashboard Cite

Microbial infections of the cornea are potentially devastating and can result in permanent visual loss or require vision-rescuing surgery. In recent years, there has been an increasing number of reports on nontuberculous mycobacterial infections of the cornea. Challenges to the management of nontuberculous mycobacterial keratitis include delayed laboratory detection, low index of clinical suspicion, poor drug penetration, slow response to therapy, and prolonged use of antibiotic combinations. The ability of nontuberculous mycobacteria to evade the host immune response and the ability to adhere and to form biofilms on biological and synthetic substrates contribute to the issue. Therefore, there is an urgent need for new antimicrobial compounds that can overcome these problems. In this study, we evaluated the biofilm architectures for Mycobacterium chelonae and Mycobacterium fortuitum in dynamic flow cell chamber and 8-well chamber slide models. Our results showed that mycobacterial biofilms were quite resistant to conventional antibiotics. However, DNase treatment could be used to overcome biofilm resistance. Moreover, we successfully evaluated a new antimicrobial compound (AM-228) that was effective not only for planktonic mycobacterial cells but also for biofilm treatment and was compared favorably with the most successful “fourth-generation” fluoroquinolone, gatifloxacin. Finally, a new treatment strategy emerged: a combination of DNase with an antibiotic was more effective than an antibiotic alone.

show abstract

“…It is important to keep in mind that this is not a rule, and more rapidly growing NTM such as the Mycobacterium chelonae-abscessus group may present as soon as 10 days posterior to the refractive surgery. [1,33,34] Innoculation of NTM to the flap-stromal interface probably takes place at the time of surgery, therefore, it is infrequent to find an epithelial defect, being present in less than half of cases. Corneal infiltrates appear to be entirely within the lamellar flap or at the flap interface and may be either multiple, tiny, white, granular opacities less than 0.5mm in diameter or a single white lesion ranging between 0.1-0.2mm in diameter.…”

Section: Clinical Featuresmentioning

confidence: 99%

“…The average time that took from the onset of symptoms to the stabishment of correct diagnosis in patients that underwent previous surgical therapy was 4.25 weeks, which results similar to the average of weeks reported in literature (3.5 weeks). [1,33,34] In our hospital 15,028 LASIK surgeries were performed from 2001-2011. We report in our service a total of 4 cases ok infectious keratitis following a LASIK procedure, which resembles an incidence of 1 infection every 3,757 procedures (0.026%).…”

Section: Our Experiencementioning

confidence: 99%

“…Lastly, considering antibiotic resistance as an emerging problem; Ford et al reported in their study that more than 60% of atypical mycobacteria are unresponsive to second-generation fluoroquinolones. [5,34] Lazar et al reported a torpid answer to the use of Rifampin in nontuberculous mycobacteria ocular infections. In our experience, we required to add a new antibiotic drug in patient 1 (Table 6), when we reached the three antibiotics suggested by diverse authors in literature (Amikacin, Clarythromicin and Gatifloxacin).…”

Section: Our Experiencementioning

confidence: 99%

See 1 more Smart Citation

Nontuberculous Mycobacterial Keratitis

Pérez-Balbuena¹,

Ancona‐Lezama²,

LorenaGutiérrez-Sánchez³

et al. 2013

Common Eye Infections

View full text Add to dashboard Cite

Addi"ional informa"ion is available a" "he end of "he chap"er h""p://dx.doi.org/10.5772/45964 . IntroductionMycobacterium species that are considered typical are the tuberculosis species such as M.tuberculosis, M.bovis, M.africarium and M.leprae. These species have only human or animal reservoirs and are not transmitted by water. In contrast, the species Non-Tuberculosis or atypical , naturally are ubiquitous in soil and water and have been found as normal flora of skin, sputum, and gastric contents. These bacteria are resistant to common, disinfectants, chlorine, formaldehyde and glutaraldehyde.NTM can cause infections on all adnexal and ocular tissues including the cornea, iris, lens, retina, choroid and optic nerve. Most NTM infections are caused by M.chelonae and M. fortuitum, that as we will discuss later, belong to the rapid growers group.In this chapter, we will focus on keratitis caused by atypical mycobacterium, since a great number of recent clinical reports of NTM ocular infections are of keratitis. In common general ophthalmology procedures like refractive surgery, for example laser in situ keratomileusis L"SIK , Laser epithelial keratomileusis L"SEK , photorefractive keratectomy PRK , and other specialized procedures such as penetrating keratoplasty PKP , a transgression to natural barriers occurs, this constitutes a risk factor for infection by these organisms. In addition, L"SIK is one of the most commonly performed procedures in ophthalmology practice.Several factors may contribute to the development of mycobacterial keratitis following L"-SIK, making it difficult to determine the true origin of the infection in most cases. This procedure is often performed utilizing aseptic, but non sterile techniques. Mycobacterium © 2013 Pérez-Balb"ena e" al.; licensee InTech. This is an open access ar"icle dis"rib""ed "nder "he "erms of "he Crea"ive Commons A""rib""ion License (h""p://crea"ivecommons.org/licenses/by/3.0), which permi"s "nres"ric"ed "se, dis"rib""ion, and reprod"c"ion in any medi"m, provided "he original work is properly ci"ed. chelonei, M. abscessus, M. fortuitum, M. szulgai, and M. mucogenicum have been reported as the result of improper asepsis."typical Mycobacteria corneal infections are rare, but devastating complications. "lthough rare, are a diagnostic and therapeutic challenge. Mycobacterium have been involved in several isolated cases as well as in outbreaks. [ -] . Microbiological and laboratory profileMycobacterium species that are considered typical are the tuberculosis specie M.tuberculosis. Many species enclosed in genus Mycobacteriaceae are true human pathogens as Mycobacterium tuberculosis complex, that include M tuberculosis, M bovis, non pathogenic M bovis "CG, M africanum, M caprae, M microti, and M pinnipedii are characterized by different phenotypes and mammalian host ranges, displays the most extreme genetic homogeneity with . to . % nucleotides variation only. Growth rate in this group is to weeks. M leprae is the only non cultivable in vitro specie and has some genet...

show abstract

Atypical mycobacteria keratitis after laser in situ keratomileusis unresponsive to fourth-generation fluoroquinolone therapy

Abstract: We report a case of post-laser in situ keratomileusis atypical mycobacteria infection unresponsive and resistant to fourth-generation fluoroquinolones, which highlights the importance of a high level of suspicion and the need for multidrug therapy for effective eradication.

Cited by 22 publications

References 18 publications

Nontuberculous Mycobacterial Ocular Infections: A Systematic Review of the Literature

Nontuberculous Mycobacterial Ocular Infections: A Systematic Review of the Literature

Biofilms of Pathogenic Nontuberculous Mycobacteria Targeted by New Therapeutic Approaches

Nontuberculous Mycobacterial Keratitis

Contact Info

Product

Resources

About