Epidemiology and Outcomes of Kocuria Keratitis

Pedro-Aguilar, Lucero; Ramírez-Miranda, Arturo; Lucio, Víctor Manuel Bautista-de; Navas, Alejandro; Ortiz-Casas, Mariana; Graue-Hernández, Enrique O

doi:10.1097/icl.0000000000000173

Cited by 17 publications

(7 citation statements)

References 27 publications

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“…In a retrospective study from China describing the causative organisms in infectious endophthalmitis, 1/330 cases reported was reported as Kocuria [ 17 ]. While cases of Kocuria keratitis have been reported previously with variable visual outcome [ 18 , 19 ], this is the first detailed description of endophthalmitis caused by Kocuria sp. Kocuria is a member of the Micrococcaceae family and currently includes 18 species [ 1 , 2 , 20 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical presentations, management outcomes, and diagnostic dilemma in Kocuria endophthalmitis

Dave¹,

Joseph²,

Pathengay³

et al. 2018

J Ophthal Inflamm Infect

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AimTo describe the clinical presentations and management outcomes of Kocuria endophthalmitis and discuss diagnostic dilemmasDesignRetrospective interventional comparative case seriesInterventionEight unilateral cases with culture-proven Kocuria endophthalmitis from January 2013 to December 2017 underwent vitrectomy/vitreous biopsy and intravitreal antibiotic with or without additional procedures. The undiluted vitreous was subjected to microbiologic evaluation.Main outcome measuresThe mean age at presentation, etiology, number of interventions, interval between inciting event and presentation, type of intravitreal antibiotic used, and anatomic and functional outcomes were reported. A favorable anatomic outcome was defined as preservation of the globe, absence of hypotony, attached retina, and absence of active inflammation at the last visit.ResultsIn the current series, there were five males and three females. The mean age at presentation was 31 ± 17.44 years (median 30 years). The inciting event was open globe injury in five cases and one case each following cataract surgery, microbial keratitis, and endogenous cause. Visual acuity was ≥ 20/400 in one case at presentation and ≥ 20/400 in three cases at the last visit. The species identified by Vitek 2, included Kocuria kristinae in three, K. rosea in four and K. varians in one. Follow-up period was 8.25 ± 8.24 months (median 6.5). Six cases (75%) had complete resolution of infection and inflammation at the last visit. Anatomic success was achieved in 75%.ConclusionsKocuria is a relatively rare cause of endophthalmitis often misdiagnosed as Staphylococcal endophthalmitis. Clinical presentation can be variable but favorable antibiotic susceptibility and appropriate timely management can result in acceptable visual and anatomic outcomes.

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Section: Discussionmentioning

confidence: 99%

Clinical presentations, management outcomes, and diagnostic dilemma in Kocuria endophthalmitis

Dave¹,

Joseph²,

Pathengay³

et al. 2018

J Ophthal Inflamm Infect

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“…Different studies have shown that these species are related to skin diseases such as dermatitis ( 41 , 42 ), where over-colonization of these microbial species has been found, especially in areas where there are numerous sebaceous glands (as occurs in the eyelids) ( 43 ). Within the allergic groups, a considerable number of subjects reported having suffered from dermatitis at some point in their lives, so it is not unreasonable to think that they continued to have active skin disorders or blepharitis, making the ocular surface an appropriate place for the expansion of these species.…”

Section: Discussionmentioning

confidence: 99%

Conjunctival Intraepithelial Lymphocytes, Lacrimal Cytokines and Ocular Commensal Microbiota: Analysis of the Three Main Players in Allergic Conjunctivitis

et al. 2022

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Conjunctival intraepithelial lymphocytes, tear soluble molecules and commensal microbiota have important roles in the ocular mucosal immune response in healthy and diseased subjects. For the purpose of this study, the cellular and microbial populations of the conjunctiva and the lacrimal soluble molecules were analyzed to find the main biomarkers in allergic conjunctivitis. A total of 35 healthy subjects, 28 subjects with seasonal allergic conjunctivitis and 32 subjects with perennial allergic conjunctivitis were recruited to obtain peripheral blood, conjunctival brush cytology, tear fluid and microbiota samples. Flow cytometry for lymphocytes, multiplex bead assays for cytokines and high-throughput DNA sequencing for microbiome analysis were used. For perennial allergic conjunctivitis, an increased proportion of Th2 and NKT lymphocytes was found, while CD3+TCRγδ+ lymphocytes and double negative MAIT cells were decreased. In contrast, seasonal allergic conjunctivitis was distinguished by an increase in Th17 and Th22 cell proportions, while the Th1 cell proportion decreased. Among tear fluid, the vast majority of pro-inflammatory cytokines (especially Th2 and Th17 cytokines) in perennial allergies and MMP-9 together with IgA in seasonal allergies were increased. In contrast, TGF-β2 was decreased in both forms of conjunctivitis. Finally, fungal (Malassezia species) and bacterial (Kocuria and Propionobacterium acnes species) colonization were observed in the perennial allergic conjunctivitis group. These results provide the basis for the development of a disease profile for perennial allergic conjunctivitis and open the door to new therapeutic and diagnostic strategies.

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“…Kocuria spp. are also unusual causative organisms in ocular infectious diseases, and there are a small number of reports on Kocuria keratitis [5, 6]. …”

Section: Introductionmentioning

confidence: 99%

Atopic keratoconjunctivitis complicated by Kocuria koreensis keratitis: the first case

Inada

Shoji

Yamagami

2017

Allergy Asthma Clin Immunol

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BackgroundPatients with atopic dermatitis have a predisposition to Staphylococcus aureus and a Herpes simplex virus infection. The treatment of atopic diseases with steroid and immunosuppressive agents induces opportunistic infection. However, there is a concern regarding visual prognosis in patients with atopic keratoconjunctivitis (AKC) complicated with infectious keratitis. We report an unusual case of an atopic shield ulcer with Kocuria keratitis.Case presentationA 51-year-old Japanese man presented with a 14-day history of eye pain and visual loss in his left eye. At the initial examination, a shield ulcer was observed in the upper-central cornea of the left eye, and the conjunctiva in both eyes had a velvety appearance due to papillary formation, as well as hyperemia and swelling in the palpebral area. The shield ulcer showed white stromal opacification in the marginal zone with a coral-like appearance. Samples were obtained by corneal scraping, and Kocuria sp. was identified by microbiological examination including culture and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. The 16S rRNA gene sequence analysis was performed using isolated Kocuria strain from the patient. The obtained DNA sequence showed 99% homology with Kocuria koreensis. The combination of corneal scraping and instillation of cefmenoxime antibiotic ophthalmic solution was considered useful for the treatment of Kocuria keratitis.ConclusionClinicians should be aware of Kocuria keratitis as a corneal complication of AKC, and that rapid diagnosis of Kocuria keratitis may improve visual prognosis.

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Epidemiology and Outcomes of Kocuria Keratitis

Cited by 17 publications

References 27 publications

Clinical presentations, management outcomes, and diagnostic dilemma in Kocuria endophthalmitis

Clinical presentations, management outcomes, and diagnostic dilemma in Kocuria endophthalmitis

Conjunctival Intraepithelial Lymphocytes, Lacrimal Cytokines and Ocular Commensal Microbiota: Analysis of the Three Main Players in Allergic Conjunctivitis

Atopic keratoconjunctivitis complicated by Kocuria koreensis keratitis: the first case

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