Treatment-Resistant Bacterial Keratitis: Challenges and Solutions

Sait Egrilmez,1 Şeyda Yildirim-Theveny2 1Private Office, Izmir, Turkey; 2Adiyaman University, Training and Research Hospital, Adiyaman, TurkeyCorrespondence: Sait EgrilmezPrivate Office, 1593/1 Sok. No: 4 B Blok D: 41 Mansuroglu Mah, Bayrakli, Izmir 35535, TurkeyTel +90 505 4504765Email saitegrilmez...

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Autores principales:	Egrilmez S, Yildirim-Theveny Ş
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2020
Materias:	bacterial keratitis antibiotic resistance multidrug resistant corneal crosslinking Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/37be3f7698654c8ab4f06546f0ad3420
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spelling	oai:doaj.org-article:37be3f7698654c8ab4f06546f0ad34202021-12-02T05:33:15ZTreatment-Resistant Bacterial Keratitis: Challenges and Solutions1177-5483https://doaj.org/article/37be3f7698654c8ab4f06546f0ad34202020-01-01T00:00:00Zhttps://www.dovepress.com/treatment-resistant-bacterial-keratitis-challenges-and-solutions-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Sait Egrilmez,1 Şeyda Yildirim-Theveny2 1Private Office, Izmir, Turkey; 2Adiyaman University, Training and Research Hospital, Adiyaman, TurkeyCorrespondence: Sait EgrilmezPrivate Office, 1593/1 Sok. No: 4 B Blok D: 41 Mansuroglu Mah, Bayrakli, Izmir 35535, TurkeyTel +90 505 4504765Email saitegrilmez@gmail.comAbstract: Bacterial keratitis is an important ophthalmic emergency and one of the most common causes of corneal blindness. The main causes of treatment resistance in bacterial keratitis are failure to eliminate predisposing factors, misdiagnosis and mistreatment. At first, exogenous, local and systemic predisposing factors that disturbing ocular surface must be eliminated to improve corneal ulcers and to prevent recurrences. Smears and scrapings for staining and culture are indispensable diagnostic tools for cases of sight-threatening keratitis (centrally located, multifocal, characterized by melting, painful). Main treatment agents in bacterial keratitis treatment are topical antibiotics. Until the results of culture antibiograms reach the ophthalmologist, empirical antibiotic selections based on direct microscopic examination and gram stain findings are the most appropriate initial treatment approach currently. S. aureus and coagulase-negative staphylococci (CoNS), the most common gram-positive agents, have resistance rates of more than 30% for fluoroquinolone and methicillin. Multidrug resistance rates are similarly high in these microorganisms. P. aeruginosa is the most common gram-negative micro-organism, in case of multidrug-resistant isolates, both functional and anatomical prognosis of the eyes are very poor. In cases of sight-threatening and resistant keratitis, antibiotic susceptibility testing containing imipenem, colistin, and linezolid is seeming to be an important requirement. Despite its efficiency limited to superficial cases, a nonpharmaceutical anti-infective treatment option such as corneal crosslinking for bacterial keratitis is an emerging hope, while antibiotic resistance increases.Keywords: bacterial keratitis, antibiotic resistance, multidrug resistant, corneal crosslinkingEgrilmez SYildirim-Theveny ŞDove Medical Pressarticlebacterial keratitisantibiotic resistancemultidrug resistantcorneal crosslinkingOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 14, Pp 287-297 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	bacterial keratitis antibiotic resistance multidrug resistant corneal crosslinking Ophthalmology RE1-994
spellingShingle	bacterial keratitis antibiotic resistance multidrug resistant corneal crosslinking Ophthalmology RE1-994 Egrilmez S Yildirim-Theveny Ş Treatment-Resistant Bacterial Keratitis: Challenges and Solutions
description	Sait Egrilmez,1 Şeyda Yildirim-Theveny2 1Private Office, Izmir, Turkey; 2Adiyaman University, Training and Research Hospital, Adiyaman, TurkeyCorrespondence: Sait EgrilmezPrivate Office, 1593/1 Sok. No: 4 B Blok D: 41 Mansuroglu Mah, Bayrakli, Izmir 35535, TurkeyTel +90 505 4504765Email saitegrilmez@gmail.comAbstract: Bacterial keratitis is an important ophthalmic emergency and one of the most common causes of corneal blindness. The main causes of treatment resistance in bacterial keratitis are failure to eliminate predisposing factors, misdiagnosis and mistreatment. At first, exogenous, local and systemic predisposing factors that disturbing ocular surface must be eliminated to improve corneal ulcers and to prevent recurrences. Smears and scrapings for staining and culture are indispensable diagnostic tools for cases of sight-threatening keratitis (centrally located, multifocal, characterized by melting, painful). Main treatment agents in bacterial keratitis treatment are topical antibiotics. Until the results of culture antibiograms reach the ophthalmologist, empirical antibiotic selections based on direct microscopic examination and gram stain findings are the most appropriate initial treatment approach currently. S. aureus and coagulase-negative staphylococci (CoNS), the most common gram-positive agents, have resistance rates of more than 30% for fluoroquinolone and methicillin. Multidrug resistance rates are similarly high in these microorganisms. P. aeruginosa is the most common gram-negative micro-organism, in case of multidrug-resistant isolates, both functional and anatomical prognosis of the eyes are very poor. In cases of sight-threatening and resistant keratitis, antibiotic susceptibility testing containing imipenem, colistin, and linezolid is seeming to be an important requirement. Despite its efficiency limited to superficial cases, a nonpharmaceutical anti-infective treatment option such as corneal crosslinking for bacterial keratitis is an emerging hope, while antibiotic resistance increases.Keywords: bacterial keratitis, antibiotic resistance, multidrug resistant, corneal crosslinking
format	article
author	Egrilmez S Yildirim-Theveny Ş
author_facet	Egrilmez S Yildirim-Theveny Ş
author_sort	Egrilmez S
title	Treatment-Resistant Bacterial Keratitis: Challenges and Solutions
title_short	Treatment-Resistant Bacterial Keratitis: Challenges and Solutions
title_full	Treatment-Resistant Bacterial Keratitis: Challenges and Solutions
title_fullStr	Treatment-Resistant Bacterial Keratitis: Challenges and Solutions
title_full_unstemmed	Treatment-Resistant Bacterial Keratitis: Challenges and Solutions
title_sort	treatment-resistant bacterial keratitis: challenges and solutions
publisher	Dove Medical Press
publishDate	2020
url	https://doaj.org/article/37be3f7698654c8ab4f06546f0ad3420
work_keys_str_mv	AT egrilmezs treatmentresistantbacterialkeratitischallengesandsolutions AT yildirimthevenys treatmentresistantbacterialkeratitischallengesandsolutions
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Treatment-Resistant Bacterial Keratitis: Challenges and Solutions

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