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ARMOR study: Antibiotic resistance high among staphylococci
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BALTIMORE – Researchers found high levels of antibiotic resistance among staphylococci, along with many isolates demonstrating multidrug resistance, in preliminary results for ocular isolates collected in 2016 under the ARMOR program, presented at the Association of Research in Vision and Ophthalmology annual meeting.
The ongoing Antibiotic Resistance Monitoring in Ocular micRoorganisms (ARMOR) is a nationwide antibiotic resistance surveillance program specific to ocular pathogens.
Staphylococcus aureus, coagulase-negative staphylococci (CoNS), Streptococcus pneumoniae, Pseudomonas aeruginosa and Haemophilus influenzae isolates were collected and subjected to antibiotic testing.
A total of 359 isolates were collected from 11 U.S. sites.
The preliminary data indicate that nonsusceptibility to fluoroquinolones (7%) more than doubled from 2015, although resistance among P. aeruginosa isolates remained low.
Isolates of S. pneumoniae exhibited nonsusceptibility to azithromycin (31%) and penicillin (38%) while, those remaining were susceptible to fluoroquinolones and chloramphenicol.
Resistance rates for S. aureus and CoNS generally remained steady when compared to 2015 data, according to researchers.
Among all staphylococci, resistance was notable for azithromycin (47% to 63%), oxacillin/methicillin (27% to 43%) and ciprofloxacin (25% to 30%), with CoNS isolates also exhibiting high levels of nonsusceptibility to tobramycin (20%) and trimethoprim (36%).
Nonsusceptibility to three or more drug classes was observed in 24% of S. aureus and 36% of CoNS isolates collected in 2016, with multidrug resistance remaining prevalent among methicillin-resistant S. aureus and methicillin-resistant CoNS, according to researchers.
High levels of antibiotic resistance among staphylococci was observed, especially in methicillin-resistant strains, with many isolates exhibiting multidrug resistance. Researchers recommend continued surveillance of ocular pathogens and consideration of ARMOR data before initiating treatment of common eye infections. – by Abigail Sutton
Reference:
Sanfilippo CM, et al. Antibiotic resistance in ocular pathogens – An update from the 2016 ARMOR surveillance program. Presented at: Association of Research in Vision and Ophthalmology annual meeting; May 7–11, 2017; Baltimore, Md.
Disclosure: Sanfilippo is employed by Bausch + Lomb. Please see full abstract for remaining authors’ disclosures.
Perspective
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Penny A. Asbell, MD, FACS, MBA
These most recent data from the ARMOR study emphasize previous findings that antimicrobial resistance continues to be a serious threat to ocular health. With high resistance observed among ocular staphylococci, eye care professionals are encouraged to limit overprescribing, cycle between antibiotic classes, avoid prolonged treatment regimens and stress to their patients the importance of dosing compliance.
Multidrug resistance continues to be an issue, especially for methicillin-resistant organisms. ARMOR results, regional surveillance data and local antibiograms should be consulted where available to understand current antibiotic resistance levels and trends over time, and thereby assist clinicians with selecting effective agents for patients.
I am pleased that Bausch + Lomb is continuing its support of ARMOR through 2017 and likely beyond so that the ophthalmology and optometry communities can consider the data collected and make informed treatment decisions.
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