Trends in Infectious Keratitis in Taiwan: An Update on Predisposing Factors, Microbiological and Antibiotic Susceptibility Patterns

Wang, Jin-Jhe; Lai, Chia-Yun; Chen, Chau-Yin; Liu, Chia‐Yen; Lin, Meng‐Hung; Wu, Pengguang

doi:10.3390/diagnostics12092095

Cited by 4 publications

(6 citation statements)

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“…First, we found a low number of pathogens recovered from microbial scrapping (<50%) that might be due to previously given antimicrobial therapy, this was similar to a recent study in Taiwan, that only recovered 3990 pathogens from 7807 corneal scraping cultures (51.1%) therefore we could not differentiate the IL-6 changes between different causative pathogens. [ 17 ] Second, no data regarding predisposing risk factors on the treatment effect of lysate. Future studies who include the predisposing factors in the analysis will give a better understanding of the effect of lysate on the disease.…”

Section: Discussionmentioning

confidence: 99%

Decreased levels of interleukin-6 level in tears and clinical changes in subjects with moderate-to-severe infection corneal ulcers treated with platelet-rich fibrin lysate eye drops

Rakhmandani,

Mahayana,

Widyaputri

et al. 2023

Taiwan Journal of Ophthalmology

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PURPOSE: To assess the change of interleukin-6 (IL-6) levels in tears and ocular clinical parameters in corneal ulcer patients with moderate-to-severe infection after adjunctive therapy with platelet-rich fibrin (PRF) lysate-eyedrops compared with autologous serum eyedrops. MATERIALS AND METHODS: This study was a randomized double-blind controlled trial, which compared two groups of patients at Dr. Sardjito Hospital, Yogyakarta. A total of 42 patients (42 eyes) were divided into the control group (21 patients) and the intervention group (21 patients). All patients received antibacterial/antifungal therapy based on the etiology, and an adjunctive eyedrop therapy: autologous serum eyedrops for the control group and PRF lysate eyedrops for the intervention group. The IL-6 levels and clinical changes in patients, such as the area of corneal defects, pericorneal injection, and the level of blepharospasm were measured at the baseline, day 6, and day 13 after starting the treatment. RESULTS: Compared to baseline, the mean IL-6 level in day 13 decreased by 426.6 ± 665.4 pg/ml ( P = 0.005) and 1283.7 ± 1569.1 pg/ml ( P = 0.079) in the intervention and control groups, respectively. However, the difference between the two groups was not statistically significant ( P = 0.164). In term of corneal defect area, there was a significant decrease at day 6 and day 13 in both groups but there was no statistically significant difference between the two groups in all time points. Similarly, the proportion of blepharospasm and pericorneal injection severity appeared to improve especially on day 13 in both groups but were not statistically different between the two. CONCLUSION: There was a statistically significant decrease in IL-6 levels in the tears in patient using PRF lysate, but there was no significant difference when compared to those using autologous serum. The difference in defect area, degree of blepharospasm, and pericorneal injection was not statistically significant between the two treatment options.

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Section: Discussionmentioning

confidence: 99%

Decreased levels of interleukin-6 level in tears and clinical changes in subjects with moderate-to-severe infection corneal ulcers treated with platelet-rich fibrin lysate eye drops

Rakhmandani,

Mahayana,

Widyaputri

et al. 2023

Taiwan Journal of Ophthalmology

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“…A male predominance was found in our study with 74.7% males and 25.3% females. Similar to our study Wang JJ., et al [7],…”

Section: Treatment and Its Outcomesmentioning

confidence: 96%

Clinical and Microiological Profile of Infective Keratitis in a Tertiary Care Hospital in North India

Mittal¹,

Nagpal²,

Bakshi³

et al. 2023

Act Sci Oph

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Introduction:Infective Keratitis refers to the diseases affecting cornea caused by infective agents which leads to necrosis and suppuration resulting in corneal tissue ulcers. It is a potentially blinding condition that must be treated emergently to preserve vision. Fungal corneal ulcers are the most common, accounting for 30-40% of the cases followed by bacterial, viral and amoebic corneal ulcers.Methods: It was a prospective, open labelled, interventional study including 75 patients of infective keratitis reporting to the Ophthalmology OPD at Rajindra Hospital, Patiala. Cases diagnosed with microbial keratitis were evaluated clinically using slit lamp biomicroscope and microbiologically using smears and cultures. The patients were treated accordingly and followed up to analyze the treatment response and outcomes in these patients.Results: Out of 75 patients enrolled in the study, 31 were diagnosed to have fungal keratitis (41.3%), 22 had bacterial keratitis (29.3%) and 6 had mixed infection (8%). 9 patients were diagnosed with viral keratitis based on the clinical picture. Aspergillus was the most commonly isolated fungal species followed by Fusarium and Staphylococcus was the most common isolated bacteria. Fungal keratitis took the longest to heal and had maximum complications compared to other etiologies. Conclusion:Being an agricultural state the incidence of fungal keratitis is much more in Punjab compared to other microbes. Treating a fungal corneal ulcer is very challenging inspite of the available diagnostic and treatment methods.

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“…For Gram-positives, five studies found 0%-29% resistance to cephalosporins [84][85][86][87][88] ; four studies reported 0%-52% resistance to aminoglycosides 84,[86][87][88] ; and six studies 0%-47% resistance to fluoroquinolones. [84][85][86][87][88][89] For Gram-negatives, five studies found 0%-50% resistance to cephalosporins 88 ; and seven studies 0%-48% resistance to aminoglycosides and 3%-57% to fluoroquinolones. [84][85][86][87][88][89][90] In summary, for Gram-positives, the range of resistance to cephalosporins was similar in Australia, North America, and Asia between 0% and 35%.…”

Section: Keratitismentioning

confidence: 99%

“…[84][85][86][87][88][89] For Gram-negatives, five studies found 0%-50% resistance to cephalosporins 88 ; and seven studies 0%-48% resistance to aminoglycosides and 3%-57% to fluoroquinolones. [84][85][86][87][88][89][90] In summary, for Gram-positives, the range of resistance to cephalosporins was similar in Australia, North America, and Asia between 0% and 35%. Similarly to the range of resistance to fluoroquinolones (5%-27%) in the UK, Australia, and North America.…”

Section: Keratitismentioning

confidence: 99%

“…In Asia, for all isolates, Ng et al 83 reported 12% resistance to aminoglycosides. For Gram‐positives, five studies found 0%–29% resistance to cephalosporins 84–88 ; four studies reported 0%–52% resistance to aminoglycosides 84,86–88 ; and six studies 0%–47% resistance to fluoroquinolones 84–89 . For Gram‐negatives, five studies found 0%–50% resistance to cephalosporins 88 ; and seven studies 0%–48% resistance to aminoglycosides and 3%–57% to fluoroquinolones 84–90 …”

Section: Antimicrobial Resistance In Bacterial Ocular Infectionsmentioning

confidence: 99%

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Antimicrobial resistance in ocular infection: A review

Cabrera‐Aguas,

Chidi‐Egboka,

Kandel

et al. 2024

Clinical Exper Ophthalmology

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Antimicrobial resistance (AMR) is a global public health threat with significant impact on treatment outcomes. The World Health Organization's Global Action Plan on AMR recommended strengthening the evidence base through surveillance programs and research. Comprehensive, timely data on AMR for organisms isolated from ocular infections are needed to guide treatment decisions and inform researchers and microbiologists of emerging trends. This article aims to provide an update on the development of AMR in ocular organisms, AMR in bacterial ocular infections and on AMR stewardship programs globally. The most common ocular pathogens are Pseudomonas aeruginosa, Staphylococcus spp., Streptococcus pneumoniae, and Haemophilus influenzae in ocular infections. A variety of studies and a few surveillance programs worldwide have reported on AMR in these infections over time. Fluoroquinolone resistance has increased particularly in Asia and North America. For conjunctivitis, the ARMOR cumulative study in the USA reported a slight decrease in resistance to ciprofloxacin. For keratitis, resistance to methicillin has remained stable for S. aureus and CoNS, while resistance to ciprofloxacin has decreased for MRSA globally. Methicillin‐resistance and multidrug resistance are also emerging, requiring ongoing monitoring. Antimicrobial stewardship (AMS) programmes have a critical role in reducing the threat of AMR and improving treatment outcomes. To be successful AMS must be informed by up‐to‐date AMR surveillance data. As a profession it is timely for ophthalmology to act to prevent AMR leading to greater visual loss through supporting surveillance programmes and establishing AMS.

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Trends in Infectious Keratitis in Taiwan: An Update on Predisposing Factors, Microbiological and Antibiotic Susceptibility Patterns

Cited by 4 publications

References 51 publications

Decreased levels of interleukin-6 level in tears and clinical changes in subjects with moderate-to-severe infection corneal ulcers treated with platelet-rich fibrin lysate eye drops

Decreased levels of interleukin-6 level in tears and clinical changes in subjects with moderate-to-severe infection corneal ulcers treated with platelet-rich fibrin lysate eye drops

Clinical and Microiological Profile of Infective Keratitis in a Tertiary Care Hospital in North India

Antimicrobial resistance in ocular infection: A review

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