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Antibiotic resistance seen as problematic in Asian study of infectious keratitis
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LOS ANGELES — Antibiotic resistance is a significant problem in many Asian countries, one speaker reported in a presentation on lessons learned from the Asia Cornea Society Infectious Keratitis Study.
The aim of the multicenter, prospective, observational study launched in eight Asian countries was to determine the causes of infectious keratitis, to track the types of organisms and to determine the antibiotic resistance patterns, Donald Tan, MD, told colleagues at Cornea Subspecialty Day preceding the American Society of Cataract and Refractive Surgery meeting.
Donald Tan
“We had no shortage of infections, with around 6,500 specimens at the end of the study,” Tan said.
Of microbacterial organisms identified as causes of infectious keratitis, Pseudomonas aeruginosa was identified as the top cause in five of the countries: China, Philippines, Taiwan, Thailand and Singapore. In India, however, P. aeruginosa was second behind Streptococcus pneumoniae.
“Interestingly, in Japan and South Korea, Pseudomonas did not feature as much, but they had more gram-positive organisms. Between the different countries there was a very wide variation in the type of bacterial keratitis,” he said.
Regarding sensitivity of P. aeruginosa to antibiotics, the overall percentage of sensitivity was about 86%, Tan said. Higher antibiotic resistance was seen in the Philippines, India and China. Multidrug resistance was greatest in India and lowest in Japan, Thailand and Singapore.
“There is significant heterogeneity in infectious keratitis by geographical pattern,” Tan said, attributing differences in bacterial organism patterns to climate, for example, more Pseudomonas is present in warmer climates. There are also differences in the etiology of infectious keratitis, he said, with more contact lens-associated keratitis occurring in urban, developed countries, mostly in East Asia populations.
“The amount of data generated in this study will keep us going for many years,” Tan said. “I’ve just selected Pseudomonas as the first cut.” Phase 2 of the study is ongoing. – by Patricia Nale, ELS
Reference:
Tan D. Asia Cornea Society Infectious Keratitis Study: What have we learned? Presented at: American Society of Cataract and Refractive Surgery annual meeting; May 5-9, 2017; Los Angeles.
Disclosure: Tan reports no relevant financial disclosures.