May 08, 2015
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ARMOR study reports changes in antibiotic resistance levels

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DENVER — The Antibiotic Resistance Monitoring in Ocular Microorganisms surveillance study showed high levels of antibiotic resistance among ocular pathogens on a nationwide scale, according to a presentation here.

In a poster presented at the Association for Research in Vision and Ophthalmology annual meeting, Penny A. Asbell, MD, FACS, MBA, and colleagues presented surveillance data from the ARMOR study of 543 isolates that were collected from 22 sites in 2013 and 140 isolates collected from seven sites in the 2014 preliminary data.

“When you look at surveillance data, you have a much better overview of what is going on in the U.S.,” she said. “What we were really familiar with in the past was that each center reported their five, six or 10 cases, and who knew if there was something odd about those few cultures or if it was really a trend?”

The survey includes isolates of Streptococcus pneumoniae, Staphylococcus aureus, coagulase-negative staphylococci (CoNS), Pseudomonas aeruginosa and Haemophilus influenzae for antibiotic susceptibility testing.

Non-susceptibility rates for S. pneumoniae isolates more than doubled for penicillin, azithromycin and chloramphenicol from 2013 to 2014.

In 2014, fewer isolates of S. aureus were non-susceptible to oxacillin, ciprofloxacin and azithromycin than in 2013.

Tobramycin non-susceptibility among CoNS increased, while oxacillin resistance rates slightly increased and azithromycin resistance rates remained stable.

“The other thing we noticed is that tobramycin is still the most popular used antibiotic in the U.S., and its non-susceptibility increased substantially,” Asbell said.

One in four S. aureus and one in two CoNS isolates were methicillin resistant, with many being multi-drug resistant.

Isolates of P. aeruginosa in 2013 were non-susceptible to polymyxin B, imipenem and ciprofloxacin.

All H. influenzae isolates were susceptible to all drugs tested, except fluoroquinolone and azithromycin.

“We definitely saw some changes, and that’s why you have to keep doing [the ARMOR study],” Asbell said. “You can’t assume that what happened in 2010, let’s say, is what’s going to be happening in 2015.”

No change is equally important as change, she said. - by Kristie L. Kahl

Disclosure: Asbell reports she has a financial interest in Bausch + Lomb.