&lt;p&gt;Multi-Drug Resistant Post Corneal Repair &lt;em&gt;Klebsiella oxytoca&lt;/em&gt;’s Keratitis&lt;/p&gt;

Regasa, Tolcha; Zewudie, Ameha; Mamo, Yitagesu; Feyissa, Desalegn; Geleta, Sinbona

doi:10.2147/imcrj.s278625

Cited by 10 publications

(6 citation statements)

References 18 publications

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“…Some of Klebsiella spp. that caused infectious keratitis are reported to be nosocomial, multi drug resistant and extended spectrum beta-lactamase producing [17][18][19]. In this series only one patient had klebsiella keratitis resistant to aminoglycosides, cephalosporins and uoroquinolones.…”

Section: Discussionmentioning

confidence: 97%

Infectious keratitis caused by Klebsiella spp.: predisposing factors, presentation, and management

et al. 2022

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To study predisposing factors, clinical presentation and management strategies for klebsiella keratitis. MethodsA retrospective case review was performed on clinical records of culture-proven klebsiella keratitis cases in a tertiary referral center over an 8-year period (from 2012 to 2020). ResultsThirty eight episodes of culture-proven klebsiella keratitis were identi ed in 37 patients. The mean age of the patients was 62.9 years (range, 24-101).. Multiple predisposing factors were identi ed in 33 eyes including history of previous keratoplasty (n = 11) history of ocular trauma (n = 7), preexisting ocular surface disease(n = 7) and diabetes(n = 6). Corrected distance visual acuity (CDVA) was light perception (LP) in 16 patients, hand motion (HM) in 12, counting ngers (CF) at 50 centimeters in 5, CF at 1 meter in 1, CF at 2 m in 2 .One patient had a CDVA of 3/10. On initial examination Hypopyon was detected in 21 eyes. Descemet's membrane folds were present in 1 eye. Corneal thinning was identi ed in 20 eyes and perforation occurred in 4 patients. Corneal ulcer progressed to endophthalmitis in one patient.Microbiologic sensitivity testing showed that 89.5% isolates were sensitive to amikacin (34/38),88.9%sensitive to ceftazidime (32/36),94.4% were sensitive to gentamicin (34/36),97.2% sensitive to cipro oxacin (35/36), and 100% to levo oxacin (26/26).Ultimately, one or more surgical procedures was needed in 21 patients. ConclusionPrevious keratoplasty, history of ocular trauma, ocular surface disease and systemic disease such as diabetes are major risk factors for Klebsiella keratitis. In most of the patients, surgical and tectonic procedures were necessary to control the infection.

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Section: Discussionmentioning

confidence: 97%

Infectious keratitis caused by Klebsiella spp.: predisposing factors, presentation, and management

et al. 2022

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“…First, the New Hampshire isolates only included those recovered from bacteremia cases and not from other infections. As K. oxytoca is also implicated in a wide range of diseases ( 3 , 5 , 9 – 11 , 14 ), other STs and AMR determinants associated with non-bacteremia infections were missed in our analyses. K. oxytoca from contaminated hospital equipment, fomites, and environments (e.g .…”

Section: Discussionmentioning

confidence: 99%

“…It is also an opportunistic pathogen that has been increasingly reported in nosocomial infections ( 6 ). K. oxytoca has been implicated in diarrhea ( 7 ), ventriculitis ( 8 ), keratitis ( 9 ), urinary tract infections ( 3 ), antibiotic-associated hemorrhagic colitis ( 10 ), necrotizing entercolitis ( 11 ), bacteremia ( 12 ), meningitis ( 13 ), and pyogenic liver abscess ( 14 ). While its prevalence in clinical settings is less than the more frequently studied Klebsiella pneumoniae , K. oxytoca is well adapted to healthcare environments ( 2 , 15 ).…”

Section: Introductionmentioning

confidence: 99%

Phylogenetic lineages and antimicrobial resistance determinants of clinical Klebsiella oxytoca spanning local to global scales

Ikhimiukor,

Souza,

Akintayo

et al. 2023

Microbiol Spectr

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Klebsiella oxytoca is an opportunistic pathogen causing serious nosocomial infections. Knowledge about the population structure and diversity of healthcare-associated K. oxytoca from a genomic standpoint remains limited. Here, we characterized the phylogenetic relationships and genomic characteristics of 20 K . oxytoca sensu stricto isolates recovered from bloodstream infections at the Dartmouth-Hitchcock Medical Center, New Hampshire, USA from 2017 to 2021. Results revealed a diverse population consisting of 15 sequence types (STs) that together harbored 10 variants of the intrinsic beta-lactamase gene bla OXY-2 , conferring resistance to penicillins. Similar sets of antimicrobial resistance (AMR) determinants reside in multiple distinct lineages, with no one lineage dominating the local population. To place the New Hampshire K. oxytoca in a broader context, we compared them to 304 publicly available genomes of clinical isolates from 18 countries. This global clinical K. oxytoca sensu stricto population is represented by over 65 STs that together harbored resistance genes against 14 antimicrobial classes, including eight bla OXY-2 variants. Three dominant STs in the global population (ST2, ST176, ST199) circulate across multiple countries and were also present in the New Hampshire population. The global K. oxytoca population is genetically diverse, but there is evidence for broad dissemination of a few lineages carrying distinct set of AMR determinants. Our findings reveal the clinical diversity of K. oxytoca sensu stricto and its importance in surveillance efforts aimed at monitoring the evolution of this drug-resistant nosocomial pathogen. IMPORTANCE The opportunistic pathogen Klebsiella oxytoca has been increasingly implicated in patient morbidity and mortality worldwide, including several outbreaks in healthcare settings. The emergence and spread of antimicrobial resistant strains exacerbate the disease burden caused by this species. Our study showed that clinical K. oxytoca sensu stricto is phylogenetically diverse, harboring various antimicrobial resistance determinants and bla OXY-2 variants. Understanding the genomic and population structure of K. oxytoca is important for international initiatives and local epidemiological efforts for surveillance and control of drug-resistant K. oxytoca .

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“…K. oxytoca has been reported as a rare cause of keratitis [ 222 ], and K. pneumoniae has been reported as a rare cause of interface keratitis following lamellar keratoplasty [ 223 ]. Although drug-resistant K. pneumoniae have been reported in Asia, 86% of endogenous bacterial endophthalmitis cases responded well to intravitreal ceftazidime [ 219 ].…”

Section: Gram-negative Ocular Pathogensmentioning

confidence: 99%

Ocular Bacterial Infections: A Ten-Year Survey and Review of Causative Organisms Based on the Oklahoma Experience

Astley,

Mursalin,

Coburn

et al. 2023

Microorganisms

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Ocular infections can be medical emergencies that result in permanent visual impairment or blindness and loss of quality of life. Bacteria are a major cause of ocular infections. Effective treatment of ocular infections requires knowledge of which bacteria are the likely cause of the infection. This survey of ocular bacterial isolates and review of ocular pathogens is based on a survey of a collection of isolates banked over a ten-year span at the Dean McGee Eye Institute in Oklahoma. These findings illustrate the diversity of bacteria isolated from the eye, ranging from common species to rare and unique species. At all sampled sites, staphylococci were the predominant bacteria isolated. Pseudomonads were the most common Gram-negative bacterial isolate, except in vitreous, where Serratia was the most common Gram-negative bacterial isolate. Here, we discuss the range of ocular infections that these species have been documented to cause and treatment options for these infections. Although a highly diverse spectrum of species has been isolated from the eye, the majority of infections are caused by Gram-positive species, and in most infections, empiric treatments are effective.

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<p>Multi-Drug Resistant Post Corneal Repair <em>Klebsiella oxytoca</em>’s Keratitis</p>

Cited by 10 publications

References 18 publications

Infectious keratitis caused by Klebsiella spp.: predisposing factors, presentation, and management

Infectious keratitis caused by Klebsiella spp.: predisposing factors, presentation, and management

Phylogenetic lineages and antimicrobial resistance determinants of clinical Klebsiella oxytoca spanning local to global scales

Ocular Bacterial Infections: A Ten-Year Survey and Review of Causative Organisms Based on the Oklahoma Experience

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