Analysis Of Microbial Keratitis Incidence, Isolates And In-Vitro Antimicrobial Susceptibility In The East Of England: A 6-Year Study
Published 2023 - 41st Congress of the ESCRS
Reference: PP17.05 | Type: Free paper | DOI: 10.82333/qt42-c933
Authors: Malik Moledina* 1 , Harry Roberts 2 , Achyut Mukherjee 3 , James Myerscough 1
1Southend University Hospital NHS Foundation Trust ,Southend-on-Sea,United Kingdom, 2Royal Devon and Exeter NHS Foundation Trust,Exeter ,United Kingdom, 3Colchester General Hospital,Colchester,United Kingdom
Purpose
To report the incidence, microbiological profile and in-vitro antimicrobial susceptibilities of microbial keratitis (MK) in the East of England (EoE) over a 6-year period.
Setting
All corneal scrape specimens reviewed by microbiology departments in participating trusts within the EoE between 01/01/2015-01/07/2020 were included. Hospitals participating were: Broomfield, Cambridge-University Hospitals, Colchester, Hinchingbrooke, Ipswich, Southend-University Hospital, and Norfolk and Norwich University Hospitals.
Methods
A retrospective study of patients diagnosed with MK who underwent corneal scraping at participating trusts, within the EoE, between 01/01/2015–01/07/2020. Analysis was performed on MK isolate profiles, in-vitro anti-microbial sensitivities and trends over time.
Results
The mean estimated incidence, is 6.96 per 100 000 population/year. 1071 scrapes were analysed, 460 were culture positive (42.95%): 87.2% were bacteria, 2.4% polymicrobial, 9.3% fungi and 1.1% acanthamoeba. The commonest organism was pseudomonas spp. There was an increasing incidence of pseudomonas spp, staph aureus and serratia (p = 0.719, 0.615, and 0.099 respectively) and a declining trend in Fungi (p = 0.058). Susceptibilities in-vitro to, penicillin classes, fluoroquinolone and aminoglycosides were 76.7%/97.2%, 89.4%/95.4% and 79.2%/96.1% to gram-positive and negative bacteria respectively. Gram-negatives had a 19.2% reduction in sensitivity to Cephalosporins (p = 0.011) with Ceftriaxone showing the largest decline (41.67% p = 0.006).
Conclusions
In the EoE, MK is relatively prevalent though likely underestimated. Profiles are similar to other UK regions with the exception of a higher fungal and lower acanthamoeba incidence. Common first and second-line antimicrobial selection provides, on the whole, good coverage. Nevertheless, anti-microbial resistance, to cephalosporins, was observed so selection should be carefully considered when treating MK empirically.