Background: The increasing drug resistance of Pseudomonas aeruginosa (PA) poses a serious challenge to the current treatment. Antibiograms of this pathogen often take 3-5 days, and treatment of Pseudomonas aeruginosa keratitis (PAK) is mainly based on preliminary physical examination, clinical experience, and medical guidelines. Pertinent clinical data on the causative agent and antibiotics for high efficacy are essential for early recognition and subsequent treatment.
Purpose: To report the etiology, risk factors, treatment outcomes, antibiotic susceptibilities, and trends of PAK.
Methods: This retrospective study included culture-proven PAK cases at the Ho Chi Minh City Eye Hospital Cornea Department between January 2018 and December 2022. Culture results showing coinfection were excluded from the study.
Results: Among 154 eyes infected by PA (n = 154) of 154 patients, ocular trauma was the leading risk factor (53.2%); only 16 patients had contact lenses (10.4%). Among the 154 eyes, 102/154 required surgical intervention (66.2%); and 31/154 eyes required evisceration (20.1%). PA was sensitive to tobramycin (95.9%), ciprofloxacin (91.9%), levofloxacin (91.9%), ofloxacin (87.4%), and moxifloxacin (20.0%). The prevalence of multidrug resistance (MDR) was 31.8%, and extensive drug resistance (XDR) was 3.9%. Poor outcomes (need for surgical intervention or final visual acuity ≤ CF 3 m) included age > 50 years, ocular surface diseases, deep infiltrate, large infiltrate size ≥ 5 mm, and ring infiltrate (p < 0.05).
Conclusion: PAK, which is associated with increasing drug resistance, poses significant challenges in terms of treatment, with 66.2% of patients requiring surgical intervention. With the rapid progression of PAK, early treatment with broad-spectrum and effective antibiotics is necessary. However, future research should focus on new methods to enhance treatment effectiveness.
Keywords: Pseudomonas aeruginosa; Antibiotic resistance; Antibiotic susceptibilities; Keratitis.
© 2024. The Author(s), under exclusive licence to Springer Nature B.V.