1
|
Tresch M, Watté C, Stengard M, Ritter C, Brodard I, Feyer S, Gohl E, Akdesir E, Perreten V, Kittl S. Corynebacterium oculi-related bacterium may act as a pathogen and carrier of antimicrobial resistance genes in dogs: a case report. BMC Vet Res 2023; 19:251. [PMID: 38031130 PMCID: PMC10763336 DOI: 10.1186/s12917-023-03821-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 11/22/2023] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND The genus Corynebacterium comprises well-known animal and human pathogens as well as commensals of skin and mucous membranes. Species formerly regarded as contaminants are increasingly being recognized as opportunistic pathogens. Corynebacterium oculi has recently been described as a human ocular pathogen but has so far not been reported in dogs. CASE PRESENTATION Here we present two cases of infection with a novel Corynebacterium sp., a corneal ulcer and a case of bacteriuria. The two bacterial isolates could not be identified by MALDI-TOF MS. While 16 S rRNA gene (99.3% similarity) and rpoB (96.6% identity) sequencing led to the preliminary identification of the isolates as Corynebacterium (C.) oculi, whole genome sequencing revealed the strains to be closely related to, but in a separate cluster from C. oculi. Antimicrobial susceptibility testing showed high minimal inhibitory concentrations of lincosamides, macrolides, tetracycline, and fluoroquinolones for one of the isolates, which also contained an erm(X) and tet-carrying plasmid as well as a nonsynonymous mutation leading to an S84I substitution in the quinolone resistance determining region of GyrA. CONCLUSIONS While the clinical signs of both dogs were alleviated by antimicrobial treatment, the clinical significance of these isolates remains to be proven. However, considering its close relation with C. oculi, a known pathogen in humans, pathogenic potential of this species is not unlikely. Furthermore, these bacteria may act as reservoir for antimicrobial resistance genes also in a One Health context since one strain carried a multidrug resistance plasmid related to pNG3 of C. diphtheriae.
Collapse
Affiliation(s)
- Milena Tresch
- Institute of Veterinary Bacteriology, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Christine Watté
- Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Michele Stengard
- Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | | | - Isabelle Brodard
- Institute of Veterinary Bacteriology, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Simon Feyer
- Institute of Veterinary Bacteriology, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Estelle Gohl
- Institute of Veterinary Bacteriology, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Ezgi Akdesir
- Institute of Veterinary Bacteriology, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Vincent Perreten
- Institute of Veterinary Bacteriology, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Sonja Kittl
- Institute of Veterinary Bacteriology, Vetsuisse Faculty, University of Bern, Bern, Switzerland.
| |
Collapse
|
2
|
Sakisaka T, Iwasaki T, Ono T, Ueda K, Nejima R, Mori Y, Noguchi Y, Yagi A, Shoji N, Miyata K. Changes in the preoperative ocular surface flora with an increase in patient age: A surveillance analysis of bacterial diversity and resistance to fluoroquinolone. Graefes Arch Clin Exp Ophthalmol 2023; 261:3231-3239. [PMID: 37261513 DOI: 10.1007/s00417-023-06121-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 05/05/2023] [Accepted: 05/18/2023] [Indexed: 06/02/2023] Open
Abstract
PURPOSE This study analyzed the relationship between patient age and the prevalence and fluoroquinolone susceptibility of gram-positive cocci from the ocular surface flora before ophthalmic surgery. METHODS This surveillance study included scraped samples from the conjunctival sac of 8923 eyes of 5490 patients (70.0 ± 13.7 years) without ocular infection before ophthalmologic surgery between August 2018 and December 2020. A review of microbiological records regarding patient age was used to determine the number of isolates and gram-positive species obtained, as well as their fluoroquinolone susceptibility. Fluoroquinolone susceptibility was determined using the Clinical and Laboratory Standards Institute protocols of broth microdilution. Statistical analysis was performed using a generalized additive model and a log-linear model. RESULTS In total, 9,894 bacterial isolates obtained from scraped samples from the patients were analyzed. The detected species were Staphylococcus epidermidis (31.0%), Staphylococcus aureus (6.1%), Staphylococcus lugdunensis (3.9%), Enterococcus faecalis (5.8%), Corynebacterium species (31.7%), and Cutibacterium acnes (7.5%) and others. The number of species isolated from the ocular surface was increased at the rate of 1.018 per 10 years of age (p < 0.0001). S. epidermidis, S. lugdunensis, E. faecalis, and Corynebacterium species were isolated more often with an increase in patient age. The levofloxacin resistance ratio of methicillin-sensitive S. epidermidis and Corynebacterium species increased at the rate of 1.204 and 1.087 respectively with a 10-year increase in age (both p < 0.0001). CONCLUSION Gram-positive bacteria in the ocular surface flora (OSF) exhibited gradual changes in diversity and fluoroquinolone resistance with an increase in patient age. It is important to monitor the OSF of the patients before ophthalmologic surgery to prevent refractory ocular postoperative infection.
Collapse
Affiliation(s)
- Toshihiro Sakisaka
- Department of Ophthalmology, Miyata Eye Hospital, 6-3 Kurahara, Miyakonojo, Miyazaki, 885-0051, Japan.
- Department of Ophthalmology, School of Medicine, Kitasato University, 1-15-1 Kitasato, Minami-Ku, Sagamihara, Kanagawa, 252-0373, Japan.
| | - Takuya Iwasaki
- Department of Ophthalmology, Miyata Eye Hospital, 6-3 Kurahara, Miyakonojo, Miyazaki, 885-0051, Japan
| | - Takashi Ono
- Department of Ophthalmology, Miyata Eye Hospital, 6-3 Kurahara, Miyakonojo, Miyazaki, 885-0051, Japan
- Department of Ophthalmology, Graduate School of Medicine and Faculty of Medicine, the University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-0033, Japan
| | - Koji Ueda
- Department of Ophthalmology, Miyata Eye Hospital, 6-3 Kurahara, Miyakonojo, Miyazaki, 885-0051, Japan
| | - Ryohei Nejima
- Department of Ophthalmology, Miyata Eye Hospital, 6-3 Kurahara, Miyakonojo, Miyazaki, 885-0051, Japan
| | - Yosai Mori
- Department of Ophthalmology, Miyata Eye Hospital, 6-3 Kurahara, Miyakonojo, Miyazaki, 885-0051, Japan
| | - Yukari Noguchi
- Department of Ophthalmology, Miyata Eye Hospital, 6-3 Kurahara, Miyakonojo, Miyazaki, 885-0051, Japan
| | - Akiko Yagi
- Department of Ophthalmology, Miyata Eye Hospital, 6-3 Kurahara, Miyakonojo, Miyazaki, 885-0051, Japan
| | - Nobuyuki Shoji
- Department of Ophthalmology, School of Medicine, Kitasato University, 1-15-1 Kitasato, Minami-Ku, Sagamihara, Kanagawa, 252-0373, Japan
| | - Kazunori Miyata
- Department of Ophthalmology, Miyata Eye Hospital, 6-3 Kurahara, Miyakonojo, Miyazaki, 885-0051, Japan
| |
Collapse
|
3
|
Astley RA, Mursalin MH, Coburn PS, Livingston ET, Nightengale JW, Bagaruka E, Hunt JJ, Callegan MC. Ocular Bacterial Infections: A Ten-Year Survey and Review of Causative Organisms Based on the Oklahoma Experience. Microorganisms 2023; 11:1802. [PMID: 37512974 PMCID: PMC10386592 DOI: 10.3390/microorganisms11071802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 06/29/2023] [Accepted: 07/10/2023] [Indexed: 07/30/2023] Open
Abstract
Ocular infections can be medical emergencies that result in permanent visual impairment or blindness and loss of quality of life. Bacteria are a major cause of ocular infections. Effective treatment of ocular infections requires knowledge of which bacteria are the likely cause of the infection. This survey of ocular bacterial isolates and review of ocular pathogens is based on a survey of a collection of isolates banked over a ten-year span at the Dean McGee Eye Institute in Oklahoma. These findings illustrate the diversity of bacteria isolated from the eye, ranging from common species to rare and unique species. At all sampled sites, staphylococci were the predominant bacteria isolated. Pseudomonads were the most common Gram-negative bacterial isolate, except in vitreous, where Serratia was the most common Gram-negative bacterial isolate. Here, we discuss the range of ocular infections that these species have been documented to cause and treatment options for these infections. Although a highly diverse spectrum of species has been isolated from the eye, the majority of infections are caused by Gram-positive species, and in most infections, empiric treatments are effective.
Collapse
Affiliation(s)
- Roger A Astley
- Department of Ophthalmology, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
| | - Md Huzzatul Mursalin
- Department of Ophthalmology, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
| | - Phillip S Coburn
- Department of Ophthalmology, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
| | - Erin T Livingston
- Department of Microbiology and Immunology, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
| | - James W Nightengale
- Department of Ophthalmology, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
| | - Eddy Bagaruka
- Department of Biology, Oklahoma Christian University, Edmond, OK 73013, USA
| | - Jonathan J Hunt
- Department of Biology, Oklahoma Christian University, Edmond, OK 73013, USA
| | - Michelle C Callegan
- Department of Ophthalmology, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
- Department of Microbiology and Immunology, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
- Dean McGee Eye Institute, Oklahoma City, OK 73104, USA
| |
Collapse
|
4
|
Soni T, Gunasekaran R, Das S, Mitra S, Prajna NV, Prajna L, Sharma S, Mohamed A. Corynebacterium Keratitis: Pure Versus Mixed Infection and Antibiotic Susceptibility Patterns From Different Tertiary Eye Care Centers. Cornea 2022; 41:1386-1391. [PMID: 34743096 DOI: 10.1097/ico.0000000000002915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Accepted: 09/13/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE The objective of this study was to compare the clinical and microbiological profiles of culture-proven pure Corynebacterium keratitis with mixed infection and their antibiotic susceptibility patterns over a 2-year period. METHODS A retrospective analysis of culture-proven cases of Corynebacterium keratitis over a 2-year period was performed in 3 different tertiary eye care centers. All isolates were tested for antibiotic susceptibility in vitro using the disc-diffusion method for 7 antibiotics. RESULTS Altogether 108 cases were identified as culture-positive Corynebacterium keratitis in 3 tertiary eye care centers. Of these, 60.2% (n = 65) and 39.8% (n = 43) of cases were due to pure Corynebacterium and mixed infection, respectively. The mean duration of symptoms was 23.2 ± 29.6 days. In the mixed-infection group, fungus was identified as the coexistent pathogen in 22 cases (51.1%). Ocular surface disorder was the most common risk factor (33.9%) in Corynebacterium keratitis. The most frequently isolated species was Corynebacterium amycolatum (22.2%) in both groups. Therapeutic keratoplasty was performed in 8.3% of cases. There was no significant difference in the outcome between the 2 groups. Cefazolin resistance was seen in 13.9% of patients, and all isolates were susceptible to vancomycin. The resistance pattern showed emerging resistance toward fluoroquinolone because the isolates were resistant to gatifloxacin (58.3%), moxifloxacin (47.2%), ciprofloxacin (54.6%), and ofloxacin (45.4%). CONCLUSIONS Ocular surface disorder is the most common risk factor in Corynebacterium keratitis. Although fluoroquinolones are commonly used as first-line therapy in microbial keratitis, the in vitro resistance pattern indicates that these are less likely to be effective in infection with Corynebacterium species.
Collapse
Affiliation(s)
- Tanvi Soni
- Cornea & Anterior Segment Service, L V Prasad Eye Institute, Bhubaneswar, Odisha, India
| | | | - Sujata Das
- Cornea & Anterior Segment Service, L V Prasad Eye Institute, Bhubaneswar, Odisha, India
| | - Sanchita Mitra
- Ocular Microbiology Service, L V Prasad Eye Institute, Bhubaneswar, Odisha, India
| | | | - Lalitha Prajna
- Department of Ocular Microbiology, Aravind Eye Hospital, Madurai, Tamil Nadu, India
| | - Savitri Sharma
- Jhaveri Microbiology Centre, L V Prasad Eye Institute, Hyderabad, Telangana, India; and
| | - Ashik Mohamed
- Department of Ophthalmic Biophysics, L V Prasad Eye Institute, Hyderabad, Telangana, India
| |
Collapse
|
5
|
Park S, Shin H, Kim S, Lee T, Lee H, Nam K, Yoon W, Kim H, Seo Y, Won Y, Kwon H. Distribution of Corynebacterium Species and Comparative Results of Diagnostic Methods for Identifying Corynebacterium in Experimental Mice in Korea. Vet Sci 2022; 9:vetsci9070328. [PMID: 35878345 PMCID: PMC9318398 DOI: 10.3390/vetsci9070328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 06/21/2022] [Accepted: 06/25/2022] [Indexed: 12/03/2022] Open
Abstract
Simple Summary Experimental mice are the most commonly used laboratory animals for biomedical research and comparative studies. However, microbial infection may alter the mouse phenotype and confound interpretation results. The genus Corynebacterium, Gram-positive diphtheroid rod-shaped bacteria, induces severe diseases, such as hyperkeratosis and pseudotuberculosis, in immunodeficient mice. In this report, we described the population of Corynebacterium spp. isolated from laboratory mice in Korea using different approaches, comparing the accuracy and problems associated with each method. When identified based on molecular methods such as 16S rRNA and rpoB gene sequence analysis, the main Corynebacterium species were C. mastitidis (44.8%), C. bovis (25.5%), C. lowii (21.2%), and C. amycolatum (8.5%). In addition, matrix-assisted laser desorption/ionization–time of flight mass spectrometry (MALDI-TOF MS) yielded results that were 77.9% identical to the molecular results, whereas biochemical methods showed only 15.5% identical to molecular identification. Collectively, our findings indicate that the different results may be obtained depending on the method used to identify Corynebacterium isolated from experimental mice, highlighting the importance of selecting an appropriate Corynebacterium identification method in obtaining accurate identification results. This result will help to increase the reliability of Corynebacterium diagnosis result from experimental mice. Abstract The genus Corynebacterium, composed of Gram-positive diphtheroid rod-shaped bacteria, induces severe diseases, such as Corynebacterium-associated hyperkeratosis and pseudotuberculosis, in immunodeficient mice. We isolated and identified a total of 165 strains of Corynebacterium species from experimental mice in Korean laboratories, diagnosed using several methods. When identified based on molecular methods, namely, 16S rRNA and rpoB gene sequence analysis, the main Corynebacterium species isolated in Korean laboratory mice were C. mastitidis (44.8%, n = 74), C. bovis (25.5%, n = 42), C. lowii (21.2%, n = 35), and C. amycolatum (8.5%, n = 14). Diagnoses were also performed using matrix-assisted laser desorption/ionization–time of flight mass spectrometry (MALDI-TOF MS) and biochemical methods. MALDI-TOF MS yielded results that were 77.9% identical to the molecular identification results, whereas biochemical methods showed only 15.5% identical to molecular identification, partly owing to difficulties in distinguishing among C. mastitidis strains. Collectively, our findings indicate that molecular biological methods are better suited for detecting and identifying Corynebacterium species candidates isolated from mice than biochemical methods. Because of limitations associated with the use of MALDI-TOF MS, more precise results will be obtained by complementing this approach with other methods when used for rapid identification testing.
Collapse
Affiliation(s)
- Sehee Park
- Laboratory Animal Resource Center, Korea Research Institute of Biology and Biotechnology, 30, Yeongudanji-ro, Cheongwon-gu, Cheongju-si 28116, Korea; (S.P.); (H.S.); (S.K.); (T.L.); (H.L.); (K.N.); (W.Y.); (H.K.); (Y.S.)
| | - Hijo Shin
- Laboratory Animal Resource Center, Korea Research Institute of Biology and Biotechnology, 30, Yeongudanji-ro, Cheongwon-gu, Cheongju-si 28116, Korea; (S.P.); (H.S.); (S.K.); (T.L.); (H.L.); (K.N.); (W.Y.); (H.K.); (Y.S.)
| | - Sangwoon Kim
- Laboratory Animal Resource Center, Korea Research Institute of Biology and Biotechnology, 30, Yeongudanji-ro, Cheongwon-gu, Cheongju-si 28116, Korea; (S.P.); (H.S.); (S.K.); (T.L.); (H.L.); (K.N.); (W.Y.); (H.K.); (Y.S.)
| | - Teakchang Lee
- Laboratory Animal Resource Center, Korea Research Institute of Biology and Biotechnology, 30, Yeongudanji-ro, Cheongwon-gu, Cheongju-si 28116, Korea; (S.P.); (H.S.); (S.K.); (T.L.); (H.L.); (K.N.); (W.Y.); (H.K.); (Y.S.)
| | - Haejin Lee
- Laboratory Animal Resource Center, Korea Research Institute of Biology and Biotechnology, 30, Yeongudanji-ro, Cheongwon-gu, Cheongju-si 28116, Korea; (S.P.); (H.S.); (S.K.); (T.L.); (H.L.); (K.N.); (W.Y.); (H.K.); (Y.S.)
| | - Kihoan Nam
- Laboratory Animal Resource Center, Korea Research Institute of Biology and Biotechnology, 30, Yeongudanji-ro, Cheongwon-gu, Cheongju-si 28116, Korea; (S.P.); (H.S.); (S.K.); (T.L.); (H.L.); (K.N.); (W.Y.); (H.K.); (Y.S.)
| | - Wonkee Yoon
- Laboratory Animal Resource Center, Korea Research Institute of Biology and Biotechnology, 30, Yeongudanji-ro, Cheongwon-gu, Cheongju-si 28116, Korea; (S.P.); (H.S.); (S.K.); (T.L.); (H.L.); (K.N.); (W.Y.); (H.K.); (Y.S.)
| | - Hyoungchin Kim
- Laboratory Animal Resource Center, Korea Research Institute of Biology and Biotechnology, 30, Yeongudanji-ro, Cheongwon-gu, Cheongju-si 28116, Korea; (S.P.); (H.S.); (S.K.); (T.L.); (H.L.); (K.N.); (W.Y.); (H.K.); (Y.S.)
| | - Youngwon Seo
- Laboratory Animal Resource Center, Korea Research Institute of Biology and Biotechnology, 30, Yeongudanji-ro, Cheongwon-gu, Cheongju-si 28116, Korea; (S.P.); (H.S.); (S.K.); (T.L.); (H.L.); (K.N.); (W.Y.); (H.K.); (Y.S.)
| | - Youngsuk Won
- Laboratory Animal Resource Center, Korea Research Institute of Biology and Biotechnology, 30, Yeongudanji-ro, Cheongwon-gu, Cheongju-si 28116, Korea; (S.P.); (H.S.); (S.K.); (T.L.); (H.L.); (K.N.); (W.Y.); (H.K.); (Y.S.)
- Correspondence: (Y.W.); (H.K.)
| | - Hyojung Kwon
- Department of Veterinary Pathology, College of Veterinary Medicine, Chungnam National University, 99, Daehak-ro, Yuseong-gu, Daejeon 34134, Korea
- Correspondence: (Y.W.); (H.K.)
| |
Collapse
|
6
|
Ocular surface flora and prophylactic antibiotics for cataract surgery in the age of antimicrobial resistance. Jpn J Ophthalmol 2022; 66:111-118. [PMID: 35006494 DOI: 10.1007/s10384-021-00899-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 09/13/2021] [Indexed: 10/19/2022]
Abstract
According to the World Health Organization alert about the antimicrobial resistance crisis released in 2015, clinicians should strongly reconsider the prolonged use of antimicrobials. In this review, we focus on the ocular surface flora with respect to the trend of fluoroquinolone resistance, and its upset and restoration after topical administration of antimicrobials and preservatives. Even 3 weeks of topical administration of levofloxacin (LVFX) yields a selection of fluoroquinolone-resistant isolates bearing genetic changes in the ocular surface flora. One month of topical prophylactic administration of LVFX after cataract surgery induces the loss of diversity with LVFX-resistance of the ocular surface flora. Restoration of LVFX-sensitive flora occurs 6 to 9 months after the final topical administration of LVFX. The ocular surface flora recovers earlier in patients given LVFX for 1 week after the surgical procedure. These findings suggest that shorter periods of postoperative topical antibiotics are less frequently associated with persistent antimicrobial-resistant bacteria in the ocular flora. In addition, microbiologic analysis of ocular surfaces treated with a long period of eye drops containing benzalkonium chloride (BAC) showed a higher incidence of isolates resistant to methicillin and fluoroquinolones than did ocular surfaces treated with eye drops not containing BAC. To avoid the emergence of antimicrobial-resistant bacteria on the ocular surface, an urgent discussion must be held about the appropriate use of antibiotics and preservatives in the ophthalmology field.
Collapse
|
7
|
Ueta M, Hosomi K, Park J, Mizuguchi K, Sotozono C, Kinoshita S, Kunisawa J. Categorization of the Ocular Microbiome in Japanese Stevens-Johnson Syndrome Patients With Severe Ocular Complications. Front Cell Infect Microbiol 2021; 11:741654. [PMID: 34869055 PMCID: PMC8640524 DOI: 10.3389/fcimb.2021.741654] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 10/26/2021] [Indexed: 01/15/2023] Open
Abstract
The commensal microbiota is involved in a variety of diseases. Our group has noticed that patients with Stevens–Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN) often present with persistent inflammation of the ocular surface, even in the chronic stage, and that this inflammation is exacerbated by colonization of the mucosa by certain bacteria. However, the changes in the composition of the ocular microbiome in SJS/TEN patients with severe ocular complications (SOCs) remain to be fully investigated. Here, we conducted a cross-sectional study of 46 Japanese subjects comprising 9 healthy control subjects and 37 SJS/TEN patients with SOC. The 16S rRNA-based genetic analyses revealed that the diversity of the ocular microbiome was reduced in SJS/TEN patients with SOC compared with that in healthy control subjects. Principal coordinate analysis based on Bray–Curtis distance at the genus level revealed that the relative composition of the ocular microbiome was different in healthy control subjects and SJS/TEN patients with SOC, and that the SJS/TEN patients with SOC could be divided into four groups based on whether their microbiome was characterized by enrichment of species in genus Corynebacterium 1, Neisseriaceae uncultured, or Staphylococcus or by simultaneous enrichment in species in genera Propionibacterium, Streptococcus, Fusobacterium, Lawsonella, and Serratia. Collectively, our findings indicate that enrichment of certain bacteria at the ocular surface could be associated with ocular surface inflammation in SJS/TEN patients with SOC.
Collapse
Affiliation(s)
- Mayumi Ueta
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Koji Hosomi
- Laboratory of Vaccine Materials, Center for Vaccine and Adjuvant Research and Laboratory of Gut Environmental System, National Institutes of Biomedical Innovation, Health and Nutrition (NIBIOHN), Ibaraki, Japan
| | - Jonguk Park
- Laboratory of Bioinformatics, Artificial Intelligence Center for Health and Biomedical Research, National Institutes of Biomedical Innovation, Health and Nutrition (NIBIOHN), Ibaraki, Japan
| | - Kenji Mizuguchi
- Laboratory of Bioinformatics, Artificial Intelligence Center for Health and Biomedical Research, National Institutes of Biomedical Innovation, Health and Nutrition (NIBIOHN), Ibaraki, Japan.,Institute for Protein Research, Osaka University, Suita, Japan
| | - Chie Sotozono
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Shigeru Kinoshita
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Jun Kunisawa
- Laboratory of Vaccine Materials, Center for Vaccine and Adjuvant Research and Laboratory of Gut Environmental System, National Institutes of Biomedical Innovation, Health and Nutrition (NIBIOHN), Ibaraki, Japan.,International Research and Development Center for Mucosal Vaccines, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan.,Graduate School of Medicine, Graduate School of Dentistry, Osaka University, Suita, Japan.,Department of Microbiology and Immunology, Kobe University Graduate School of Medicine, Kobe, Japan
| |
Collapse
|
8
|
Chen H, Bai X, Gao Y, Liu W, Yao X, Wang J. Profile of Bacteria with ARGs Among Real-World Samples from ICU Admission Patients with Pulmonary Infection Revealed by Metagenomic NGS. Infect Drug Resist 2021; 14:4993-5004. [PMID: 34866919 PMCID: PMC8636693 DOI: 10.2147/idr.s335864] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 11/16/2021] [Indexed: 12/27/2022] Open
Abstract
Background Treatment of pulmonary infections in the intensive care unit (ICU) represents a great challenge, especially infections caused by antibiotic resistance pathogens. A thorough and up-to-date knowledge of the local spectrum of antibiotic resistant bacteria can improve the antibiotic treatment efficiency. In this study, we aimed to reveal the profile of bacteria with antibiotic resistance genes (ARGs) in real-world samples from ICU admission patients with pulmonary infection in Mainland, China, by metagenomic next-generation sequencing (mNGS). Methods A total of 504 different types of clinical samples from 452 ICU admission patients with pulmonary infection were detected by mNGS analysis. Results A total of 485 samples from 434 patients got successful mNGS results. Among 434 patients, one or more bacteria with ARGs were detected in 192 patients (44.24%, 192/434), and ≥2 bacteria with ARGs were detected in 85 (19.59%, 85/434) patients. The predominant detected bacteria were Corynebacterium striatum (C. striatum) (11.76%, 51/434), Acinetobacter baumannii (A. baumannii) (11.52%, 50/434) and Enterococcus faecium (E. faecium) (8.99%, 39/434). ermX conferred resistance to MSLB and cmx to phenicol were the only two ARGs detected in C. striatum; in A. baumannii, most of ARGs were resistance-nodulation-division (RND)-type efflux pumps genes, which conferred resistance to multi-drug; ermB conferred resistance to MSLB and efmA to multi-drug were the predominant ARGs in E. faecium. Bacteria with ARGs were detected in 50% (140/280) bronchoalveolar lavage fluid (BALF) and 50.5% (48/95) sputum samples, which were significantly higher than in blood and cerebrospinal fluid (CSF) samples. Conclusion High level of bacteria with ARGs was observed in clinical samples, especially BALF and sputum samples from ICU admission patients with pulmonary infection in Mainland, China. And C. striatum resistant to MSLB and/or phenicol, multi-drug resistance A. baumannii and E. faecium were the lead bacteria.
Collapse
Affiliation(s)
- Huijuan Chen
- Department of Biomedical Engineering, College of Life Science and Bioengineering, Beijing University of Technology, Beijing, People's Republic of China
| | - Xinhua Bai
- Department of Clinical Laboratory, Beijing Capitalbio Medlab, Beijing, People's Republic of China
| | - Yang Gao
- Department of Clinical Laboratory, Beijing Capitalbio Medlab, Beijing, People's Republic of China
| | - Wenxuan Liu
- Department of Clinical Laboratory, Beijing Capitalbio Medlab, Beijing, People's Republic of China
| | - Xuena Yao
- Department of Clinical Laboratory, Beijing Capitalbio Medlab, Beijing, People's Republic of China
| | - Jing Wang
- Department of Clinical Laboratory, Beijing Capitalbio Medlab, Beijing, People's Republic of China
| |
Collapse
|
9
|
Fong P, Butel-Simoes G, Francis MJ, Korman TM, Graham M. Corynebacterium macginleyi in the era of MALDI-TOF MS: epidemiology, susceptibility patterns and prevalence of co-infection. Pathology 2021; 54:336-343. [PMID: 34635321 DOI: 10.1016/j.pathol.2021.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 07/01/2021] [Accepted: 07/08/2021] [Indexed: 11/28/2022]
Abstract
Corynebacterium macginleyi has long been associated with ocular infections and has more recently been rarely implicated in systemic infections. There is a paucity of literature regarding the rate of C. macginleyi co-infection with other bacterial and viral pathogens and regarding the incidence of C. macginleyi infection in the paediatric population. In this study, we report 30 isolates of C. macginleyi of ocular origin from 26 patients, identified using matrix-assisted laser desorption ionisation-time of flight mass spectrometry (MALDI-TOF MS). The rates of co-isolation with bacterial and viral pathogens were 62% (n=16/26) and 39% (n=5/13), respectively, in this study. Of these, 13 patients had molecular testing performed as requested by treating clinicians for either the Chlamydia trachomatis/Neisseria gonorrhoeae PCR or herpes/enterovirus/adenovirus multiplex PCR. All isolates tested susceptible to linezolid, vancomycin and ciprofloxacin, with variable resistance to tetracycline, clindamycin and penicillin using EUCAST breakpoints.
Collapse
Affiliation(s)
- Peivern Fong
- Department of Microbiology, Monash Health, Clayton, Vic, Australia.
| | | | | | - Tony M Korman
- Department of Microbiology, Monash Health, Clayton, Vic, Australia; Monash Infectious Diseases, Monash Health, Clayton, Vic, Australia; Centre for Inflammatory Diseases, Monash University, Clayton, Vic, Australia
| | - Maryza Graham
- Department of Microbiology, Monash Health, Clayton, Vic, Australia; Monash Infectious Diseases, Monash Health, Clayton, Vic, Australia; Centre for Inflammatory Diseases, Monash University, Clayton, Vic, Australia; Microbiological Diagnostic Unit Public Health Laboratory, University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Vic, Australia
| |
Collapse
|
10
|
Nakanishi T, Inose R, Kusama Y, Ishikane M, Kajihara T, Yahara K, Sugai M, Ohge H, Ohmagari N, Muraki Y. The use of topical antibiotics based on National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB) Open Data in 2017. Jpn J Infect Dis 2021; 75:177-182. [PMID: 34588368 DOI: 10.7883/yoken.jjid.2021.450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The national action plan on antimicrobial resistance (AMR) in Japan emphasizes the importance of understanding antimicrobial use (AMU). Some studies have been conducted on oral and parenteral AMU in Japan. However, there are few studies on the use of topical antimicrobials, such as in dermatology and ophthalmology. Therefore, the purpose of this study was to investigate topical AMU in Japan. Data on AMU in dermatology and ophthalmology were obtained from the 2017 National Database of Health Insurance Claims and Specific Health Checkups of Japan Open Data. The number of dermatological products used was 58,396,530 in 2017. The proportion of betamethasone/gentamicin was 50.5% and that of gentamicin 16.7%, whereas that of the ingredient quantity in gentamicin was 7.8%. It was suggested that topical AMU should be evaluated by the number of products. The number of ophthalmological products used was 24,655,653 in 2017, and the proportion of quinolones was 95.9%. The high prescription rate of quinolones may cause an increase in quinolone resistance in the ophthalmologic field. Topical AMU, which is a potential "blind spot" in the measures against AMR, needs to be continuously monitored, together with systemic AMU.
Collapse
Affiliation(s)
- Tomoko Nakanishi
- Department of Clinical Pharmacoepidemiology, Kyoto Pharmaceutical University, Japan
| | - Ryo Inose
- Department of Clinical Pharmacoepidemiology, Kyoto Pharmaceutical University, Japan
| | - Yoshiki Kusama
- AMR Clinical Reference Center, Disease Control and Prevention Center, National Center for Global Health and Medicine, Japan
| | - Masahiro Ishikane
- AMR Clinical Reference Center, Disease Control and Prevention Center, National Center for Global Health and Medicine, Japan
| | - Toshiki Kajihara
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Japan
| | - Koji Yahara
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Japan
| | - Motoyuki Sugai
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Japan
| | - Hiroki Ohge
- Department of Infectious Diseases, Hiroshima University Hospital, Japan
| | - Norio Ohmagari
- AMR Clinical Reference Center, Disease Control and Prevention Center, National Center for Global Health and Medicine, Japan
| | - Yuichi Muraki
- Department of Clinical Pharmacoepidemiology, Kyoto Pharmaceutical University, Japan
| |
Collapse
|
11
|
Elsheikh M, Elsayed A, Bennett N, Connor M. Corynebacterium Bovis: A Rare Case of Persistent Bacterial Keratitis and Corneal Perforation. Cureus 2021; 13:e16913. [PMID: 34513486 PMCID: PMC8412843 DOI: 10.7759/cureus.16913] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/05/2021] [Indexed: 11/29/2022] Open
Abstract
We report a rare case of severe, non-contact lens-related Corynebacterium bovis corneal infection on a background of viral keratitis, resulting in corneal abscess formation with subsequent corneal perforation. An 89-year-old Caucasian lady presented with a significant epithelial defect and a dense stromal infiltrates on a background of herpes zoster keratitis, ultimately resulting in corneal perforation. Enrichment culture obtained from corneal scraping isolated the unusual organism Corynebacterium bovis. This was treated with a combination of culture-directed, targeted course of antibiotics and surgical interventions. To the best of our knowledge, this is the first reported case of profuse bacterial keratitis secondary to Corynebacterium bovis infiltration, on a background of viral keratitis, resulting in corneal abscess formation and subsequent perforation. This report highlights this rare bacterium’s characteristics including its pathogenicity in causing severe corneal disease, particularly in immunosuppressed environments such as in this case, apparent antibiotic sensitivities & resistance, and potential transmission route.
Collapse
Affiliation(s)
| | - Ahmed Elsayed
- Ophthalmology, NHS Dumfries & Galloway, Dumfries, GBR
| | | | - Martin Connor
- Microbiology, NHS Dumfries & Galloway, Dumfries, GBR
| |
Collapse
|
12
|
Corynebacterium Species of the Conjunctiva and Nose: Dominant Species and Species-Related Differences of Antibiotic Susceptibility Profiles. Cornea 2021; 39:1401-1406. [PMID: 32773445 DOI: 10.1097/ico.0000000000002445] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE Nondiphtherial Corynebacterium species are normal residents of human skin and mucosa, including the conjunctiva and nose, but can cause conjunctivitis and keratitis. Recently, resistance against various classes of antibiotics has been reported in Corynebacterium. The present study investigated the type of species and antibiotic susceptibilities of the conjunctival and nasal Corynebacterium species. METHODS This study examined 183 strains of Corynebacterium species that were isolated from patients undergoing preoperative examinations for cataract surgery. Species were identified by RNA polymerase β-subunit-encoding gene (rpoB) sequencing. Antibiotic susceptibility tests were performed by the microdilution method according to the Clinical and Laboratory Standards Institute standard method M45. RESULTS Corynebacterium macginleyi was the most predominant species (84%; 46 of 55) in the conjunctiva. The 2 major species in the nasal cavity were Corynebacterium accolens and Corynebacterium propinquum (44% and 31%, respectively), followed by Corynebacterium pseudodiphtheriticum (8%), Corynebacterium jeikeium (7%), and C. macginleyi (3%). In contrast to other nasal Corynebacterium species, only C. macginleyi showed a high susceptibility to macrolides. However, among nonconjunctival Corynebacterium species, C. propinquum, was unique in having a high resistance rate to levofloxacin (29%), comparable with that observed in C. macginleyi (36%). Penicillin G and tobramycin showed good susceptibility in almost all strains. CONCLUSIONS Drug resistance against fluoroquinolones and macrolides was observed in Corynebacterium species, with the antibiotic susceptibility profiles correlating with differences of the species and niche. Nasal and conjunctival Corynebacterium profiles of drug resistance suggest habitat segregation strictly at the species level.
Collapse
|
13
|
Clinical and genomic features of Corynebacterium macginleyi-associated infectious keratitis. Sci Rep 2021; 11:6015. [PMID: 33727638 PMCID: PMC7966771 DOI: 10.1038/s41598-021-85336-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 02/23/2021] [Indexed: 11/09/2022] Open
Abstract
Infectious keratitis is a potentially sight threatening ophthalmological emergency. Contact lens wear is a common risk factor. Diagnostic advances such as MALDI-TOF MS provides new insights into the spectrum of corneal pathogens and on microbes previously considered as commensals. Corynebacterium macginleyi was described in 1995, and in 2018, the genomic features of three isolates were reported after whole-genome sequencing. Here we describe the clinical characteristics of patients with infectious keratitis (n = 29) presumably caused by Corynebacterium macginleyi, and analyze the genomic features of C. macginleyi (n = 22) isolated from the corneal ulcers of these patients. The disease course was uneventful apart from minor interventions such as corneal cross-linking and amniotic membrane transplant. Genome sequencing and comparison revealed a highly conserved core genome of C. macginleyi. Based on the analyses of single nucleotide polymorphisms, the population could be divided into two main clades that also differed in a few clade-specific genomic islands. Patients infected with an isolate belonging to the minor clade (n = 7) presented a more severe disease. Comparisons with other corynebacterial species clearly separated C. macginleyi. C. macginleyi may be considered a corneal pathogen; genomic analysis provided insights into its population structure and disease-causing potential.
Collapse
|
14
|
Ranjith K, Sharma S, Shivaji S. Microbes of the human eye: Microbiome, antimicrobial resistance and biofilm formation. Exp Eye Res 2021; 205:108476. [PMID: 33549582 DOI: 10.1016/j.exer.2021.108476] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 01/19/2021] [Accepted: 01/22/2021] [Indexed: 01/21/2023]
Abstract
BACKGROUND The review focuses on the bacteria associated with the human eye using the dual approach of detecting cultivable bacteria and the total microbiome using next generation sequencing. The purpose of this review was to highlight the connection between antimicrobial resistance and biofilm formation in ocular bacteria. METHODS Pubmed was used as the source to catalogue culturable bacteria and ocular microbiomes associated with the normal eyes and those with ocular diseases, to ascertain the emergence of anti-microbial resistance with special reference to biofilm formation. RESULTS This review highlights the genetic strategies used by microorganisms to evade the lethal effects of anti-microbial agents by tracing the connections between candidate genes and biofilm formation. CONCLUSION The eye has its own microbiome which needs to be extensively studied under different physiological conditions; data on eye microbiomes of people from different ethnicities, geographical regions etc. are also needed to understand how these microbiomes affect ocular health.
Collapse
Affiliation(s)
- Konduri Ranjith
- Jhaveri Microbiology Centre, Brien Holden Eye Research Centre, L. V. Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, Telangana, India.
| | - Savitri Sharma
- Jhaveri Microbiology Centre, Brien Holden Eye Research Centre, L. V. Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, Telangana, India.
| | - Sisinthy Shivaji
- Jhaveri Microbiology Centre, Brien Holden Eye Research Centre, L. V. Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, Telangana, India.
| |
Collapse
|
15
|
Aoki T, Kitazawa K, Deguchi H, Sotozono C. Current Evidence for Corynebacterium on the Ocular Surface. Microorganisms 2021; 9:microorganisms9020254. [PMID: 33513871 PMCID: PMC7912348 DOI: 10.3390/microorganisms9020254] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Revised: 01/18/2021] [Accepted: 01/22/2021] [Indexed: 11/16/2022] Open
Abstract
Corynebacterium species are commonly found in the conjunctiva of healthy adults and are recognized as non-pathogenic bacteria. In recent years, however, Corynebacterium species have been reported to be potentially pathogenic in various tissues. We investigated Corynebacterium species on the ocular surface and reviewed various species of Corynebacterium in terms of their antimicrobial susceptibility and the underlying molecular resistance mechanisms. We identified a risk for Corynebacterium-related ocular infections in patients with poor immunity, such as patients with diabetes or long-term users of topical steroids, and in those with corneal epithelial damage due to trauma, contact lens wear, lagophthalmos, and trichiasis. The predominant strain in the conjunctiva was C. macginleyi, and the species associated with keratitis and conjunctivitis were C. macginleyi, C. propinquum, C. mastitidis, C. pseudodiphtheriticum, C. accolens, C. striatum, C. xerosis, and C. bovis. Overall, Corynebacterium species present on the ocular surface were resistant to quinolones, whereas those in the nasal cavity were more susceptible. The prevalence of fluoroquinolone-resistant Corynebacterium has not changed in the past 10 years; however, Corynebacterium species remain susceptible to third-generation cephems. In conclusion, the use of third-generation cephems should be a reasonable and pragmatic approach for treatment of ocular infections caused by Corynebacterium species.
Collapse
|
16
|
Eguchi H, Nishida K, Hotta F, Shimomura Y, Kusaka S. In Vitro Antimicrobial Activity of Quinolones Against Major Bacterial Isolates from the Ocular Surface Bacterial Flora of Tertiary Hospital Patients in Japan. J Ocul Pharmacol Ther 2021; 37:84-89. [PMID: 33395563 DOI: 10.1089/jop.2020.0091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Purpose: To determine the in vitro antimicrobial activity of quinolones against major bacterial isolates from the ocular surface bacterial flora of patients in a tertiary hospital for selection of optimal antibiotic eye drop during the perioperative stage. Methods: The conjunctival sac scraping of 933 patients who underwent ophthalmic surgery was cultivated and bacterial species of the isolates were identified. The minimum inhibitory concentrations (MICs) of gatifloxacin (GFLX), moxifloxacin (MFLX), levofloxacin (LVFX), and tosufloxacin (TFLX) were measured by microdilution methods. The cumulative percentages of MICs of 4 quinolones against major bacteria were calculated. The concentrations of quinolones inhibiting 50% (MIC50) and 90% (MIC90) of the major bacteria were compared. Results: The study mainly included 784 patients scheduled for cataract surgery, 73 for vitrectomy, 30 for corneal transplantation, 30 for conjunctival surgery, 11 for eyelid surgery. The most frequently isolated bacterium was coagulase-negative Staphylococci (CNS) (184 strains), followed by Corynebacterium (107 strains), Staphylococcus aureus (33 strains), Streptococcus (18 strains), and Enterococcus (13 strains). The percentages of methicillin-sensitive CNS isolates for which MIC of GFLX, MFLX, LVFX, and TFLX was 0.06 μg/mL or less were 8.0%, 13.4%, 5.4%, and 63.4%, respectively. Similarly, the percentage for Corynebacterium was 23.0%, 23.0%, 0%, and 35.6%, respectively. MIC50 of TFLX for Streptococcus and Enterococcus showed the lowest values, 0.12 and 0.25 μg/mL, respectively. Conclusions: Among 4 quinolones, TFLX has the highest in vitro antimicrobial activity against major bacterial isolates from the ocular surface bacterial flora of patients in a tertiary hospital.
Collapse
Affiliation(s)
- Hiroshi Eguchi
- Department of Ophthalmology, Kindai University Faculty of Medicine, Osakasayama-shi, Japan
| | - Koichi Nishida
- Department of Ophthalmology, Kindai University Faculty of Medicine, Osakasayama-shi, Japan
| | - Fumika Hotta
- Department of Ophthalmology, Kindai University Faculty of Medicine, Osakasayama-shi, Japan
| | | | - Shunji Kusaka
- Department of Ophthalmology, Kindai University Faculty of Medicine, Osakasayama-shi, Japan
| |
Collapse
|
17
|
Chen Z, Jiang J, Xu J, Yang X, Yang Y, Wang K, Song H, Yang B, Cho P. Antibiotic eye drops prescription patterns by orthokeratology practitioners in China and the development of antibiotic usage guidelines. Cont Lens Anterior Eye 2020; 44:101354. [PMID: 32798156 DOI: 10.1016/j.clae.2020.07.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 07/29/2020] [Accepted: 07/31/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE To investigate antibiotic eye drops prescribing patterns of contact lens practitioners in Mainland China for orthokeratology (ortho-k) patients and to develop guidelines for their use. METHODS A questionnaire on their antibiotic prescribing habits was administered to eye care practitioners (ECP) involved in ortho-k lens fitting nationwide via an official online account. Multiple logistic regression models were used to assess the relationships between prescribing habits and demographics. RESULTS A total of 555 ECP completed the survey, of whom 50.5 % were optometrists (non-medical degree). About 30 % of the respondents routinely prescribed antibiotic eye drops for prophylactic use before and/or after commencement of ortho-k treatment. Forty one percent of the respondents dispensed antibiotics to patients for emergency use without giving written instructions, 48.5 % used antibiotic eye drops to wet fluorescein strips during ortho-k lens fitting, and 44.9 % considered treating corneal infiltrate(s) with antibiotics to be appropriate. A set of guidelines, including when to use antibiotic eye drops during ortho-k lens treatment and their proper use, stratified by different corneal conditions, was developed. CONCLUSIONS Inappropriate use of antibiotic eye drops appeared to be common among ortho-k practitioners in Mainland China. Taking into account deficiencies and errors identified from the survey, a set of guidelines based on best practice was developed and can serve to provide advice for proper use of antibiotics in ortho-k practice.
Collapse
Affiliation(s)
- Zhi Chen
- Department of Ophthalmology and Vision Science, Fudan University Eye and ENT Hospital, Shanghai, China; NHC Key Laboratory of Myopia, Fudan University, Laboratory of Myopia, Chinese Academy of Medical Sciences, China.
| | - Jun Jiang
- The Eye Hospital of Wenzhou Medical University, Wenzhou, China
| | - Jingjing Xu
- The Eye Hospital of Wenzhou Medical University, Wenzhou, China
| | - Xiao Yang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangzhou, China
| | - Yin Yang
- Department of Ophthalmology, Sichuan Academy of Medical Sciences, Sichuan Provincial People's Hospital, Medical College, University of Electronic Science and Technology, Chengdu, China
| | - Kai Wang
- Department of Ophthalmology, Peking University People's Hospital, College of Optometry, Peking University Health Science Center, Beijing, China
| | - Hongxin Song
- Beijing Tongren Eye Center, Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing Key Laboratory of Ophthalmology and Visual Sciences, National Engineering Research Center for Ophthalmology, Beijing, China
| | - Bi Yang
- Department of Optometry and Visual Science, West China School of Medicine, Sichuan University, Chengdu, China
| | - Pauline Cho
- School of Optometry, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region
| |
Collapse
|
18
|
Ramos JN, Valadão TB, Baio PVP, Mattos-Guaraldi AL, Vieira VV. Novel mutations in the QRDR region gyrA gene in multidrug-resistance Corynebacterium spp. isolates from intravenous sites. Antonie van Leeuwenhoek 2019; 113:589-592. [PMID: 31736013 PMCID: PMC7089888 DOI: 10.1007/s10482-019-01353-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 10/18/2019] [Indexed: 12/16/2022]
Abstract
The resistance to fluoroquinolones in corynebacteria is due to mutations occurring in the quinolone-resistance-determining region (QRDR) of the gyrA gene encoding the enzyme gyrase A subunit. In recent years we can observe an increasing number of infections caused by multidrug-resistant Corynebacterium striatum, Corynebacterium jeikeium and Corynebacterium urealyticum, including wide range of disorders, such as invasive infections. In this study 14 Corynebacterium spp. isolated from intravenous sites were sequenced and new combinations of mutations in the QRDR of the gyrA gene were found in C. jeikeium and C. urealyticum. Nowadays, no study comparing mutations in this region and the susceptibility to fluoroquinolones in C. jeikeium and C. urealyticum has been described. All the isolates that showed double mutation (position 87 and 91) in the QRDR gyrA gene had high MIC to the fluoroquinolones tested.
Collapse
Affiliation(s)
- Juliana Nunes Ramos
- Instituto Nacional de Controle de Qualidade em Saúde (INCQS), Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil
- Laboratório de Difteria e Corinebactérias de Importância Clínica (LDCIC), Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Talita Bernardo Valadão
- Instituto Nacional de Controle de Qualidade em Saúde (INCQS), Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil
- Laboratório Interdisciplinar de Pesquisas Médicas (LIPMED), Instituto Oswaldo Cruz, Fundação Oswaldo Cruz (FIOCRUZ), Av. Brasil, 4365, Pavilhão Cardoso Fontes, 10 andar, sala 17, Manguinhos, Rio de Janeiro, RJ, CEP 21040-900, Brazil
| | - Paulo Victor Pereira Baio
- Laboratório de Difteria e Corinebactérias de Importância Clínica (LDCIC), Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
- Laboratório Químico-Farmacêutico do Exército (LQFEx), Ministério da Defesa, Rio de Janeiro, Brazil
| | - Ana Luiza Mattos-Guaraldi
- Laboratório de Difteria e Corinebactérias de Importância Clínica (LDCIC), Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Verônica Viana Vieira
- Laboratório Interdisciplinar de Pesquisas Médicas (LIPMED), Instituto Oswaldo Cruz, Fundação Oswaldo Cruz (FIOCRUZ), Av. Brasil, 4365, Pavilhão Cardoso Fontes, 10 andar, sala 17, Manguinhos, Rio de Janeiro, RJ, CEP 21040-900, Brazil.
| |
Collapse
|
19
|
Abstract
PURPOSE The purpose of this study was to report a rare case of posttrabeculectomy bleb-related infection associated with Corynebaterium macginleyi, a rare conjunctival pathogen. METHODS Case description including clinical imaging and microbiology data, and literature review of Corynebacterium macginleyi-related infections. RESULTS A 60-year-old glaucomatous female patient presented with a bleb-related infection 6 years after trabeculectomy in her right eye, suggestive of blebitis. No bleb-related endophthalmitis was reported. CONCLUSIONS C. macginleyi is a rare conjunctival pathogen that can cause conjunctivitis and, rarely, bleb-related infections.
Collapse
|
20
|
Microbiological Profile of Infectious Keratitis in a Portuguese Tertiary Centre. J Ophthalmol 2019; 2019:6328058. [PMID: 31772767 PMCID: PMC6854955 DOI: 10.1155/2019/6328058] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 09/25/2019] [Indexed: 12/02/2022] Open
Abstract
The microbiological profile of infectious keratitis has shown great differences across the world. Due to the continuous shifting trends in microbiological profile and antibiotic resistance patterns reported in several studies, constant local updates are crucial to provide an adequate treatment. The propose of this study was to analyze the incidence of infectious keratitis, possible changing trends in microbiological profile, and bacteria sensitivity to commonly used antibiotics, in our tertiary center, in the last 10 years. A retrospective study was performed, based on the survey review of electronic medical records of all patients with presumed infectious keratitis, between January 1, 2009, and December 31, 2018. Microbial cultures were performed, and patients were treated according to an internal protocol. A total of 1360 samples were included. We obtained a 35.1% culture-positive rate. Bacteria accounted for 76.78% of all positive scrapes (53.34% were Gram positive and 23.44% were Gram negative), Acanthamoeba for 12.13%, fungi for 8.16%, and virus for 2.93%. The most frequent agent identified was Corynebacterium macginleyi (18.41%), followed by Staphylococcus aureus (17.78%), Streptococcus pneumoniae (9.41%), and Pseudomonas aeruginosa (9.00%). We identified at least one ophthalmologic risk factor in 410 patients (85.77%). Trauma and contact lens wear were the most common risk factors found, accounting for 34.94% (n = 167) and 33.47% (n = 160) of cases. Sensitivity to fluoroquinolones and aminoglycosides was tested in all bacterial isolates, presenting values of 96.66% and 98.12%. In our region, the most common bacteria are Staphylococcus aureus, Streptococcus pneumoniae, and Pseudomonas aeruginosa, and they showed high sensitivity rates to first-line antibiotics, without any modification or emergence of antibiotic resistance trends during the 10 years of the study. For this reason, we decided to maintain the same internal protocol in our tertiary centre.
Collapse
|
21
|
Lorenzo D. Chloramphenicol Resurrected: A Journey from Antibiotic Resistance in Eye Infections to Biofilm and Ocular Microbiota. Microorganisms 2019; 7:microorganisms7090278. [PMID: 31438629 PMCID: PMC6780676 DOI: 10.3390/microorganisms7090278] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 08/18/2019] [Accepted: 08/20/2019] [Indexed: 01/13/2023] Open
Abstract
The advent of multidrug resistance among pathogenic bacteria is devastating the worth of antibiotics and changing the way of their administration, as well as the approach to use new or old drugs. The crisis of antimicrobial resistance is also due to the unavailability of newer drugs, attributable to exigent regulatory requirements and reduced financial inducements. The emerging resistance to antibiotics worldwide has led to renewed interest in old drugs that have fallen into disuse because of toxic side effects. Thus, comprehensive efforts are needed to minimize the pace of resistance by studying emergent microorganisms and optimize the use of old antimicrobial agents able to maintain their profile of susceptibility. Chloramphenicol is experiencing its renaissance because it is widely used in the treatment and prevention of superficial eye infections due to its broad spectrum of activity and other useful antimicrobial peculiarities, such as the antibiofilm properties. Concerns have been raised in the past for the risk of aplastic anemia when chloramphenicol is given intravenously. Chloramphenicol seems suitable to be used as topical eye formulation for the limited rate of resistance compared to fluoroquinolones, for its scarce induction of bacterial resistance and antibiofilm activity, and for the hypothetical low impact on ocular microbiota disturbance. Further in-vitro and in vivo studies on pharmacodynamics properties of ocular formulation of chloramphenicol, as well as its real impact against biofilm and the ocular microbiota, need to be better addressed in the near future.
Collapse
Affiliation(s)
- Drago Lorenzo
- Clinical Microbiology, Department of Biomedical Science for Health, University of Milan, 20133 Milan, Italy.
| |
Collapse
|
22
|
Ramos JN, Souza C, Faria YV, da Silva EC, Veras JFC, Baio PVP, Seabra SH, de Oliveira Moreira L, Hirata Júnior R, Mattos-Guaraldi AL, Vieira VV. Bloodstream and catheter-related infections due to different clones of multidrug-resistant and biofilm producer Corynebacterium striatum. BMC Infect Dis 2019; 19:672. [PMID: 31357945 PMCID: PMC6664767 DOI: 10.1186/s12879-019-4294-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 07/17/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Corynebacterium striatum is an emerging multidrug-resistant (MDR) pathogen associated with immunocompromised and chronically ill patients, as well as nosocomial outbreaks. In this study, we characterized 23 MDR C. striatum isolated of bloodstream and catheter-related infections from a hospital of Rio de Janeiro. METHODS C. striatum isolates were identified by 16S rRNA and rpoB genes sequencing. The dissemination of these isolates was accomplished by pulsed-field gel electrophoresis (PFGE). All isolates were submitted to antimicrobial susceptibility testing by disk diffusion and by minimum inhibitory concentration using E-test strips methods. Antimicrobial resistance genes were detected by polymerase chain reaction. Quantitative tests were performed on four different abiotic surfaces and the ability to produce biofilm on the surface of polyurethane and silicone catheter was also demonstrated by scanning electron microscopy. RESULTS Eleven PFGE profiles were found. The PFGE profile I was the most frequently observed among isolates. Five different MDR profiles were found and all PFGE profile I isolates presented susceptibility only to tetracycline, vancomycin, linezolid and daptomycin. Only the multidrug-susceptible isolate did not show mutations in the quinolone-resistance determinant region (QRDR) of the gyrA gene and was negative in the search of genes encoding antibiotic resistance. The other 22 isolates were positive to resistance genes to aminoglycoside, macrolides/lincosamides and chloramphenicol and showed mutations in the QRDR of the gyrA gene. Scanning electron microscopy illustrated the ability of MDR blood isolate partaker of the epidemic clone (PFGE profile I) to produce mature biofilm on the surface of polyurethane and silicone catheter. CONCLUSIONS Genotyping analysis by PFGE revealed the permanence of the MDR PFGE profile I in the nosocomial environment. Other new PFGE profiles emerged as etiologic agents of invasive infections. However, the MDR PFGE profile I was also found predominant among patients with hematogenic infections. The high level of multidrug resistance associated with biofilm formation capacity observed in MDR C. striatum is a case of concern.
Collapse
Affiliation(s)
- Juliana Nunes Ramos
- Laboratório de Difteria e Corinebactérias de Importância Clínica, Faculdade de Ciências Médicas, Centro Colaborador e Referência para pesquisa de Difteria/Ministério da Saúde, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
- Instituto Nacional de Controle de Qualidade em Saúde, Fundação Oswaldo Cruz, INCQS/FIOCRUZ, Rio de Janeiro, Brazil
- Laboratório Interdisciplinar de Pesquisas Médicas (LIPMED), Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Av. Brasil, 4365, Pavilhão Cardoso Fontes, 10 andar, sala 17, Manguinhos, Rio de Janeiro, 21040-900 Brazil
| | - Cassius Souza
- Laboratório de Difteria e Corinebactérias de Importância Clínica, Faculdade de Ciências Médicas, Centro Colaborador e Referência para pesquisa de Difteria/Ministério da Saúde, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | - Yuri Vieira Faria
- Laboratório de Difteria e Corinebactérias de Importância Clínica, Faculdade de Ciências Médicas, Centro Colaborador e Referência para pesquisa de Difteria/Ministério da Saúde, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
- Laboratório de Tecnologia em Bioquímica e Microscopia, Centro Universitário Estadual da Zona Oeste, Rio de Janeiro, Brazil
| | - Eliane Cristine da Silva
- Laboratório de Difteria e Corinebactérias de Importância Clínica, Faculdade de Ciências Médicas, Centro Colaborador e Referência para pesquisa de Difteria/Ministério da Saúde, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | - João Flávio Carneiro Veras
- Instituto Nacional de Controle de Qualidade em Saúde, Fundação Oswaldo Cruz, INCQS/FIOCRUZ, Rio de Janeiro, Brazil
| | - Paulo Victor Pereira Baio
- Laboratório de Difteria e Corinebactérias de Importância Clínica, Faculdade de Ciências Médicas, Centro Colaborador e Referência para pesquisa de Difteria/Ministério da Saúde, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
- Laboratório Interdisciplinar de Pesquisas Médicas (LIPMED), Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Av. Brasil, 4365, Pavilhão Cardoso Fontes, 10 andar, sala 17, Manguinhos, Rio de Janeiro, 21040-900 Brazil
| | - Sérgio Henrique Seabra
- Laboratório de Tecnologia em Bioquímica e Microscopia, Centro Universitário Estadual da Zona Oeste, Rio de Janeiro, Brazil
| | - Lilian de Oliveira Moreira
- Laboratório de Bacteriologia e Imunologia Clínica, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Raphael Hirata Júnior
- Laboratório de Difteria e Corinebactérias de Importância Clínica, Faculdade de Ciências Médicas, Centro Colaborador e Referência para pesquisa de Difteria/Ministério da Saúde, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | - Ana Luíza Mattos-Guaraldi
- Laboratório de Difteria e Corinebactérias de Importância Clínica, Faculdade de Ciências Médicas, Centro Colaborador e Referência para pesquisa de Difteria/Ministério da Saúde, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | - Verônica Viana Vieira
- Laboratório Interdisciplinar de Pesquisas Médicas (LIPMED), Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Av. Brasil, 4365, Pavilhão Cardoso Fontes, 10 andar, sala 17, Manguinhos, Rio de Janeiro, 21040-900 Brazil
| |
Collapse
|
23
|
Bang SR, Ahn M, Cho NC, You IC. Corneal Ulcer Caused by Corynebacterium macginleyi. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2019. [DOI: 10.3341/jkos.2019.60.6.582] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- So Ra Bang
- Department of Ophthalmology, Chonbuk National University Medical School, Jeonju, Korea
| | - Min Ahn
- Department of Ophthalmology, Chonbuk National University Medical School, Jeonju, Korea
- Research Institute of Clinical Medicine, Chonbuk National University, Jeonju, Korea
- Biomedical Research Institute, Chonbuk National University Hospital, Jeonju, Korea
| | - Nam Chun Cho
- Department of Ophthalmology, Chonbuk National University Medical School, Jeonju, Korea
- Research Institute of Clinical Medicine, Chonbuk National University, Jeonju, Korea
- Biomedical Research Institute, Chonbuk National University Hospital, Jeonju, Korea
| | - In Cheon You
- Department of Ophthalmology, Chonbuk National University Medical School, Jeonju, Korea
- Research Institute of Clinical Medicine, Chonbuk National University, Jeonju, Korea
- Biomedical Research Institute, Chonbuk National University Hospital, Jeonju, Korea
| |
Collapse
|
24
|
Deguchi H, Kitazawa K, Kayukawa K, Kondoh E, Fukumoto A, Yamasaki T, Kinoshita S, Sotozono C. The trend of resistance to antibiotics for ocular infection of Staphylococcus aureus, coagulase-negative staphylococci, and Corynebacterium compared with 10-years previous: A retrospective observational study. PLoS One 2018; 13:e0203705. [PMID: 30192856 PMCID: PMC6128643 DOI: 10.1371/journal.pone.0203705] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Accepted: 08/25/2018] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To retrospectively identify epidemiological trends of infection on the ocular surface and investigate trends of resistance to bacterial antibiotics compared with 10-years previous for Staphylococcus aureus, coagulase-negative staphylococci (CNS), and Corynebacterium in Japan. MATERIALS AND METHODS Bacterial isolate samples were collected from the conjunctival sacs of eyes afflicted with conjunctivitis, keratitis, dacryocystitis, and hordeolum from September 2004 through November 2005 (n = 145 isolates) and September 2014 through November 2015 (n = 195 isolates) at the Baptist Eye Institute, Kyoto, Japan. The prevalence of methicillin-resistant S. aureus (MRSA), methicillin-resistant CNS (MR-CNS), and fluoroquinolone-resistant Corynebacterium were examined, and susceptibility of isolated bacteria to levofloxacin (LVFX), cefmenoxime (CMX), chloramphenicol (CP), erythromycin (EM), vancomycin (VCM), and arbekacin (ABK) were compared between both time periods using the disc susceptibility method. RESULTS Over the 10-year period from initial to final examination, the prevalence of MRSA and MR-CNS significantly decreased from 52% to 22% (P < 0.05) and from 47% to 25% (P < 0.05), respectively, yet there was no change in the prevalence of fluoroquinolone-resistant Corynebacterium (60% and 54%; P = 0.38). Antibiotic-resistance trend analysis revealed that susceptibility to antibiotics in 2014-2015 was similar to that in 2004-2005. MRSA and MR-CNS were susceptible to CP (88%), VCM (100%), and ABK (100%), while fluoroquinolone-resistant Corynebacterium was susceptible to CMX (100%), VCM (100%), and ABK (96%). CONCLUSION The prevalence of MRSA and MR-CNS significantly decreased between the two time periods, yet more than 50% of the Corynebacterium isolates were still resistant to LVFX. Although no increase in bacterial resistance to antibiotics was found, a cautionary use of fluoroquinolone eye drops should be considered.
Collapse
Affiliation(s)
| | - Koji Kitazawa
- Baptist Eye Institute, Kyoto, Japan
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
- * E-mail:
| | | | - Eri Kondoh
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Akiko Fukumoto
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | | | - Shigeru Kinoshita
- Department of Frontier Medical Science and Technology for Ophthalmology, Kyoto, Prefectural University of Medicine, Kyoto, Japan
| | - Chie Sotozono
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| |
Collapse
|
25
|
Clinical and Microbiological Profile of Bacterial Microbial Keratitis in a Portuguese Tertiary Referral Center-Where Are We in 2015? Eye Contact Lens 2018; 44:15-20. [PMID: 27541969 DOI: 10.1097/icl.0000000000000298] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To study the microbial profile, antibiotic susceptibility pattern, risk factors, therapeutic trends, and clinical outcomes for microbial keratitis (MK) in a tertiary health care center. METHODS All cases with suspected bacterial keratitis that were followed at consultation from September 2007 to August 2015 were included. Microbial cultures were obtained and patients were managed following an internal protocol. RESULTS Two hundred thirty-five patients were included, with a mean age of 50.01±20.73 years. We obtained a 38.4% culture-positive rate, with higher proportion of gram-positives (70.8%). The commonest agents were Staphylococcus aureus (23.1%), Corynebacterium macginleyi (20.0%), and Pseudomonas aeruginosa (13.8%). Fluoroquinolone susceptibility was 97%, with no trend toward its decrease. A total of 95.7% had local risk factors, being trauma and contact lens wear the most common (28.9% each), with different age and pathogens distributions (P<0.001). Topical fluoroquinolones were first-line treatment in 99%, in association with aminoglycosides in 81.6%. Good initial response was registered in 95.9%, but 4.1% needed to step up treatment to fortified antibiotics, mainly if Pseudomonas (P=0.021). Good outcome was achieved in 81.8%, negatively affected by exposure and herpetic keratitis (P<0.001), central location (P=0.01), presence of Tyndall (P<0.001), corneal edema (P<0.001), and worse initial best-corrected visual acuity (P<0.001), but not Pseudomonas isolate (P=0.724). CONCLUSIONS Gram-positives are the most frequent pathogens and shifting trends in the isolate distribution or emergence of resistant strains were not demonstrated. The susceptibility to first-line antibiotic agents remained high. We suggest a more aggressive approach to P. aeruginosa cases or MK presenting with poor outcome variables.
Collapse
|
26
|
St Leger AJ, Desai JV, Drummond RA, Kugadas A, Almaghrabi F, Silver P, Raychaudhuri K, Gadjeva M, Iwakura Y, Lionakis MS, Caspi RR. An Ocular Commensal Protects against Corneal Infection by Driving an Interleukin-17 Response from Mucosal γδ T Cells. Immunity 2017; 47:148-158.e5. [PMID: 28709803 DOI: 10.1016/j.immuni.2017.06.014] [Citation(s) in RCA: 180] [Impact Index Per Article: 25.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 04/11/2017] [Accepted: 06/20/2017] [Indexed: 02/08/2023]
Abstract
Mucosal sites such as the intestine, oral cavity, nasopharynx, and vagina all have associated commensal flora. The surface of the eye is also a mucosal site, but proof of a living, resident ocular microbiome remains elusive. Here, we used a mouse model of ocular surface disease to reveal that commensals were present in the ocular mucosa and had functional immunological consequences. We isolated one such candidate commensal, Corynebacterium mastitidis, and showed that this organism elicited a commensal-specific interleukin-17 response from γδ T cells in the ocular mucosa that was central to local immunity. The commensal-specific response drove neutrophil recruitment and the release of antimicrobials into the tears and protected the eye from pathogenic Candida albicans or Pseudomonas aeruginosa infection. Our findings provide direct evidence that a resident commensal microbiome exists on the ocular surface and identify the cellular mechanisms underlying its effects on ocular immune homeostasis and host defense.
Collapse
Affiliation(s)
- Anthony J St Leger
- Laboratory of Immunology, National Eye Institute, NIH, Bethesda, MD 20892, USA
| | - Jigar V Desai
- Fungal Pathogenesis Unit, Laboratory of Clinical Infectious Diseases, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, MD 20892, USA
| | - Rebecca A Drummond
- Fungal Pathogenesis Unit, Laboratory of Clinical Infectious Diseases, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, MD 20892, USA
| | - Abirami Kugadas
- Department of Medicine, Division of Infectious Diseases, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Fatimah Almaghrabi
- Laboratory of Immunology, National Eye Institute, NIH, Bethesda, MD 20892, USA
| | - Phyllis Silver
- Laboratory of Immunology, National Eye Institute, NIH, Bethesda, MD 20892, USA
| | | | - Mihaela Gadjeva
- Department of Medicine, Division of Infectious Diseases, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Yoichiro Iwakura
- Center for Experimental Animal Models, Institute for Medical Sciences, Tokyo University of Science, Tokyo, Japan
| | - Michail S Lionakis
- Fungal Pathogenesis Unit, Laboratory of Clinical Infectious Diseases, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, MD 20892, USA
| | - Rachel R Caspi
- Laboratory of Immunology, National Eye Institute, NIH, Bethesda, MD 20892, USA.
| |
Collapse
|
27
|
Hayashi Y, Miyamoto T, Fujita S, Tomoyose K, Ishikawa N, Kokado M, Sumioka T, Okada Y, Saika S. Bacteriology of the conjunctiva in pre-cataract surgery patients with occluded nasolacrimal ducts and the operation outcomes in Japanese patients. BMC Ophthalmol 2017; 17:15. [PMID: 28219366 PMCID: PMC5319132 DOI: 10.1186/s12886-017-0410-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Accepted: 02/10/2017] [Indexed: 11/10/2022] Open
Abstract
Background Contamination of the conjunctiva in association with nasolacrimal duct obstruction is by all accounts a risk factor for infectious endophthalmitis post-cataract surgery. Methods All patients who underwent cataract day surgery routinely received nasolacrimal duct syringing with normal saline at the Wakayama Medical University Hospital, Japan, from 2011 to 2013. The microorganisms isolated from conjunctival swab samples of patients with occluded nasolacrimal ducts and their susceptibility to antibiotics, as well as the operation outcomes in all the patients were retrospectively investigated. Results Nasolacrimal duct obstruction was observed in 125 eyes of 90 patients (3.3%; 42 eyes of 30 male individuals, and 83 eyes of 60 female individuals) from a total of 3754 eyes of 2384 patients by using irrigation samples of nasolacrimal ducts. The mean age of the subjects with duct obstruction was 79 ± 8.5 years.. In bacterial cultures of swabs from these 125 individuals, microbial growth was detected in 56 samples (i.e. 44.8%). Coagulase-negative Staphylococcus was detected in 28 eyes, and Corynebacterium species was detected in 17 eyes. Staphylococcus aureus, excluding methicillin-resistant S. aureus was detected in seven eyes with nasolacrimal duct obstruction. Methicillin-resistant S. aureus was isolated in two eyes with nasolacrimal duct obstruction. Each case was treated with topical antibiotics based on the results of antibiotic sensitivity tests. After culturing of cotton swab samples from the conjunctiva, and using direct micrography of bacteria every 2 or 3 days after starting treatment, and once the results were negative (consecutively tested three times), the patients received cataract surgery. In the current case series, bacteria were not detected in conjunctival swabs obtained consecutively three times for 3 weeks after starting topical antibiotics in 118 eyes from 125 eyes (94.4%), and later in the remaining patients. No patient required dacryocystorhinostomy to eliminate bacterial contamination in the conjunctiva following topical antibiotic therapy. No patient developed infectious endophthalmitis at least 1-year post-cataract surgery. Conclusions All the patients receiving cataract day surgery underwent the operation after the elimination of conjunctival microorganism contamination in association with nasolacrimal duct obstruction by using appropriate topical antibiotics.
Collapse
Affiliation(s)
- Yuko Hayashi
- Department of Ophthalmology, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-0012, Japan
| | - Takeshi Miyamoto
- Department of Ophthalmology, Wakayama Medical University Kihoku Hospital, 219 Myoji, Katsuragi-cho, Itogun, Wakayama, 649-7113, Japan.
| | - Shuko Fujita
- Department of Ophthalmology, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-0012, Japan
| | - Katsuo Tomoyose
- Department of Ophthalmology, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-0012, Japan
| | - Nobuyuki Ishikawa
- Department of Ophthalmology, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-0012, Japan
| | - Masahide Kokado
- Department of Ophthalmology, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-0012, Japan
| | - Takayoshi Sumioka
- Department of Ophthalmology, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-0012, Japan
| | - Yuka Okada
- Department of Ophthalmology, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-0012, Japan
| | - Shizuya Saika
- Department of Ophthalmology, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-0012, Japan
| |
Collapse
|
28
|
Katsukawa C, Komiya T, Umeda K, Goto M, Yanai T, Takahashi M, Yamamoto A, Iwaki M. Toxigenic Corynebacterium ulcerans isolated from a hunting dog and its diphtheria toxin antibody titer. Microbiol Immunol 2017; 60:177-86. [PMID: 26853714 DOI: 10.1111/1348-0421.12364] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2015] [Revised: 01/29/2016] [Accepted: 01/03/2016] [Indexed: 01/17/2023]
Abstract
Toxigenic Corynebacterium ulcerans is a zoonotic pathogen that produces diphtheria toxin and causes a diphtheria-like illness in humans. The organism is known to infect and circulate among dogs, which can then transmit it to humans. Furthermore, previous studies have found that C. ulcerans is carried by wild animals, including game animals. In the present study, we tested hunting and companion dogs for the presence of toxigenic C. ulcerans and succeeded in isolating the bacterium from a hunting dog. Moreover, several hunting dogs had serum diphtheria antitoxin titers that were higher than the titers required for protection in humans, suggesting a history of exposure to toxigenic Corynebacterium strains. Notably, ribotyping, pulsed-field gel electrophoresis and tox gene sequencing demonstrated that the isolate from the hunting dog clustered with previously characterized C. ulcerans strains isolated from wild animals, as opposed to groups of isolates from humans and companion dogs. Interestingly, the wild animal cluster also contains an isolate from an outdoor breeding dog, which could have formed a bridge between isolates from wild animals and those from companion dogs. The results presented herein provide insight into the mechanism by which the zoonotic pathogen C. ulcerans circulates among wild animals, hunting and companion dogs, and humans.
Collapse
Affiliation(s)
- Chihiro Katsukawa
- Department of Infectious Diseases, Osaka Prefectural Institute of Public Health, 1-3-69 Nakamichi, Higashinari-ku, Osaka-shi, Osaka, 537-0025
| | - Takako Komiya
- Department of Bacteriology II, National Institute of Infectious Diseases, 4-7-1 Gakuen, Musashimurayama-shi, Tokyo, 208-0011
| | - Kaoru Umeda
- Department of Microbiology, Osaka City Institute of Public Health and Environmental Sciences, 8-34 Tojo-cho, Tennoji-ku, Osaka-shi, Osaka, 543-0026
| | - Minami Goto
- Department of Pathogenetic Veterinary Sciences, United Graduate School of Veterinary Sciences, Gifu University, 1-1 Yanagido, Gifu-shi, Gifu 501-1193, Japan
| | - Tokuma Yanai
- Department of Pathogenetic Veterinary Sciences, United Graduate School of Veterinary Sciences, Gifu University, 1-1 Yanagido, Gifu-shi, Gifu 501-1193, Japan
| | - Motohide Takahashi
- Department of Bacteriology II, National Institute of Infectious Diseases, 4-7-1 Gakuen, Musashimurayama-shi, Tokyo, 208-0011
| | - Akihiko Yamamoto
- Department of Bacteriology II, National Institute of Infectious Diseases, 4-7-1 Gakuen, Musashimurayama-shi, Tokyo, 208-0011
| | - Masaaki Iwaki
- Department of Bacteriology II, National Institute of Infectious Diseases, 4-7-1 Gakuen, Musashimurayama-shi, Tokyo, 208-0011
| |
Collapse
|
29
|
Bernard KA, Pacheco AL, Loomer C, Burdz T, Wiebe D, Huynh C, Kaplen B, Olson AB, Cnockaert M, Eguchi H, Kuwahara T, Nakayama-Imaohji H, Shiota H, Boudewijns M, Van Hoecke F, Vandamme P. Corynebacterium lowii sp. nov. and Corynebacterium oculi sp. nov., derived from human clinical disease and an emended description of Corynebacterium mastitidis. Int J Syst Evol Microbiol 2016; 66:2803-2812. [DOI: 10.1099/ijsem.0.001059] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Kathryn A. Bernard
- Department of Medical Microbiology, University of Manitoba, Winnipeg, Manitoba, Canada
- National Microbiology Laboratory-CSCHAH, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Ana Luisa Pacheco
- National Microbiology Laboratory-CSCHAH, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Courtney Loomer
- National Microbiology Laboratory-CSCHAH, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Tamara Burdz
- National Microbiology Laboratory-CSCHAH, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Deborah Wiebe
- National Microbiology Laboratory-CSCHAH, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Chris Huynh
- National Microbiology Laboratory-CSCHAH, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Brynn Kaplen
- National Microbiology Laboratory-CSCHAH, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Adam B. Olson
- National Microbiology Laboratory-CSCHAH, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Margo Cnockaert
- Laboratory of Microbiology, Faculty of Sciences, Ghent University, Ghent, Belgium
| | - Hiroshi Eguchi
- Department of Ophthalmology, Sakai Hospital, Kinki University Faculty of Medicine, Osaka, Japan
| | - Tomomi Kuwahara
- Department of Microbiology, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | | | - Hiroshi Shiota
- Department of Ophthalmology, Kaisei General Hospital, Kagawa, Japan
| | | | | | - Peter Vandamme
- Laboratory of Microbiology, Faculty of Sciences, Ghent University, Ghent, Belgium
| |
Collapse
|
30
|
Das S, Rao AS, Sahu SK, Sharma S. Corynebacterium spp as causative agents of microbial keratitis. Br J Ophthalmol 2015; 100:939-943. [PMID: 26567025 DOI: 10.1136/bjophthalmol-2015-306749] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2015] [Revised: 08/24/2015] [Accepted: 10/03/2015] [Indexed: 11/04/2022]
Abstract
PURPOSE To report the clinical and microbiological profile of keratitis caused by Corynebacterium spp. METHODS The medical and microbiology records of 22 patients, who had presented at the L V Prasad Eye Institute, Bhubaneswar, between June 2009 and December 2012, and whose corneal scrapings had yielded significant growth of Corynebacterium spp, were retrospectively reviewed. A detailed ocular examination was performed before the respective corneal scraping was sent for a microbiological work-up. The data collected from each record included age, gender, predisposing factors (ocular and systemic), clinical presentation, management and outcome of treatment. RESULTS The mean age of the patients was 43.8±24.4 years. Ocular predisposing factor was present in 14 (63.6%) eyes. Surgical intervention was required in 12 (54.5%) patients. In vitro susceptibility (Kirby-Bauer disc diffusion method) results of Corynebacterium spp to vancomycin (17/19, 89.5%), cefazolin (16/20, 80%), chloramphenicol (11/20, 55%), ofloxacin (13/19, 68.4%), ciprofloxacin (10/20, 50%) and gatifloxacin (10/19, 52.6%) were variable. Drug resistance (more than one drug) was seen in nine (40.9%) Corynebacterium isolates, of which, two (22.2%) showed multidrug resistance to three or more classes of antibiotics. CONCLUSIONS Corynebacteria can cause severe corneal infection requiring surgical intervention.
Collapse
Affiliation(s)
- Sujata Das
- Cornea and Anterior Segment Service, LV Prasad Eye Institute, Bhubaneswar, Odisha, India
| | - Av Subba Rao
- Cornea and Anterior Segment Service, LV Prasad Eye Institute, Bhubaneswar, Odisha, India
| | - Srikant K Sahu
- Cornea and Anterior Segment Service, LV Prasad Eye Institute, Bhubaneswar, Odisha, India
| | - Savitri Sharma
- Ocular Microbiology Service, LV Prasad Eye Institute, Bhubaneswar, Odisha, India
| |
Collapse
|
31
|
Corynebacterium macginleyi: A cause of ventilator associated pneumonia in an immunocompromised patient. Respir Med Case Rep 2015; 16:154-6. [PMID: 26744687 PMCID: PMC4681997 DOI: 10.1016/j.rmcr.2015.10.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Accepted: 10/19/2015] [Indexed: 11/23/2022] Open
Abstract
Purpose and Importance Corynebacterium macginleyi, a lipophilic diphtheroid from the genus Corynebacteria, is a known cause of conjunctivitis. It was recently reported as a cause of serious infections in immunocompromised individuals. It has never been reported as a cause of ventilator-associated pneumonia, that which carries a high burden and risk of mortality. Our report intends to increase awareness of a potentially lethal nosocomial bacterial infection. Observations This case reports on a 73 year old lady with metastatic lung adenocarcinoma on chemotherapy, who was hospitalized for dyspnea and diffuse pulmonary infiltrates in 2011. Trans-bronchial biopsies revealed cryptogenic organizing pneumonia. The patient improved with steroids. Failure to wean ensued with a bronchopleural fistula, increase in secretions, oxygen requirements, and appearance of new infiltrates. Two mini-BAL cultures yielded gram positive pleomorphic rods with palisade arrangement, diagnosed as C. macginleyi. Vancomycin therapy was initiated. She improved and was successfully extubated. Conclusion and relevance Non-diphtheria Corynebacteria usually form normal flora. If isolated, they are often dismissed as contaminants. C. macginleyi has emerged as a life-threatening nosocomial infection. Prompt identification and treatment are required. It is resistant to quinolones. Thus far, vancomycin is the preferred treatment.
Collapse
|
32
|
Contact Lens-Related Infectious Keratitis with White Plaque Formation Caused by Corynebacterium propinquum. J Clin Microbiol 2015; 53:3092-5. [PMID: 26179302 DOI: 10.1128/jcm.00899-15] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Accepted: 07/09/2015] [Indexed: 11/20/2022] Open
Abstract
We report the first case of Corynebacterium propinquum keratitis in the compromised cornea of a diabetic patient wearing therapeutic contact lenses. The strain was identified to the species level based on sequencing of the 16S rRNA gene and RNA polymerase β-subunit-encoding gene (rpoB). Ophthalmologists should be aware of nondiphtherial corynebacterial infection of compromised corneas.
Collapse
|
33
|
Olender A. Antibiotic resistance and detection of the most common mechanism of resistance (MLSB) of opportunistic Corynebacterium. Chemotherapy 2014; 59:294-306. [PMID: 24480817 DOI: 10.1159/000357467] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Accepted: 11/20/2013] [Indexed: 11/19/2022]
Abstract
BACKGROUND Determination of antibiotic resistance of opportunistic Corynebacterium colonizing the nose that cause infections and evaluation of the applicability of a simple method for detecting the most common constitutive-type resistance to macrolides, lincosamides and streptogramin B (MLSB). METHODS 70 isolates colonizing the nose and 70 clinical isolates of various infection sites were used and identified using APICoryne and 16S rRNA. Minimal inhibitory concentrations (MICs) were determined (Etest) for 12 antibiotics. MLSB was defined based on MIC, a simple method using two disks (erythromycin/clindamycin) and detection of the gene erm X (PCR). RESULTS There was a high percentage--in both groups at the same level--of strains with MLSB (88.5% colonizing the nose and 87.1% causing infections). Detection with the phenotypic method MLSB was confirmed genetically (erm X) in all cases. In both groups, a high percentage of resistance was found to trimethoprim/sulfamethoxazole (in both groups 71.4%), chloramphenicol (nose 44.2%/infections 37.1%), tetracycline (28 and 45.7%) and β-lactam antibiotics (18.5 and up to 32.8%). CONCLUSION Differences in antibiotic resistance were found between strains colonizing the respiratory tract and various infections. Isolates from infections more frequently exhibited multidrug resistance. The possibility of using a simple method was confirmed for MLSB detection, which can be applied to determine drug resistance in routine microbiological diagnostics of infections caused by opportunistic Corynebacterium.
Collapse
Affiliation(s)
- Alina Olender
- Department of Medical Microbiology, Medical University of Lublin, Lublin, Poland
| |
Collapse
|
34
|
Surgical Site Infection by Corynebacterium macginleyi in a Patient with Neurofibromatosis Type 1. Case Rep Infect Dis 2013; 2013:970678. [PMID: 23819079 PMCID: PMC3683466 DOI: 10.1155/2013/970678] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2013] [Accepted: 05/19/2013] [Indexed: 11/17/2022] Open
Abstract
Corynebacterium (C.) macginleyi is a gram positive, lipophilic rod, usually considered a colonizer of skin and mucosal surfaces. Several reports have associated C. macginleyi with ocular infections, such as conjunctivitis and endophthalmitis. However, even if rare, extraocular infections from C. macginleyi may occur, especially among immunocompromised patients and patients with indwelling medical devices. We report herein the first case of surgical site infection by C. macginleyi after orthopaedic surgery for the correction of kyphoscoliosis in a patient with neurofibromatosis type 1. Our patient developed a nodular granulomatous lesion of about two centimetres along the surgical scar, at the level of C4-C5, with purulent discharge and formation of a fistulous tract. Cervical magnetic resonance imaging showed the presence of a two-centimetre fluid pocket in the subcutaneous tissue. Several swabs were collected from the borders of the lesion as well as from the exudate, with isolation of C. macginleyi. The isolate was susceptible to beta-lactams, cotrimoxazole, linezolid, and glycopeptides but resistant to quinolones, third-generation cephalosporins, and erythromycin. Two 30-day courses of antibiotic therapy with amoxicillin/clavulanate (1 g three times/day) and cotrimoxazole (800/160 mg twice a day) were administered, obtaining a complete healing of the lesion.
Collapse
|
35
|
Aoki R, Fukuda K, Ogawa M, Ikeno T, Kondo H, Tawara A, Taniguchi H. Identification of Causative Pathogens in Eyes with Bacterial Conjunctivitis by Bacterial Cell Count and Microbiota Analysis. Ophthalmology 2013; 120:668-76. [DOI: 10.1016/j.ophtha.2012.10.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2012] [Revised: 10/01/2012] [Accepted: 10/01/2012] [Indexed: 11/29/2022] Open
|
36
|
Suto C, Ishizuka T, Toshida H. Iris rubeosis and hyphema caused by chemical injury due to household detergent. Clin Ophthalmol 2012; 6:1977-80. [PMID: 23226003 PMCID: PMC3514056 DOI: 10.2147/opth.s38255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
We report an unusual case of iris rubeosis and hyphema caused by chemical injury due to household detergent. A 74-year-old man with a 15-year history of diabetes mellitus was refilling a container with household detergent at home. He splashed the detergent in his eyes. Slit-lamp examination revealed extensive epithelial damage to the left eye, leading to a persistent corneal epithelial defect. We used a bandage soft contact lens with levofloxacin eye drops as concomitant therapy in order to promote healing. However, a strain of fluoroquinolone-resistant Corynebacterium colonized the eye, so that the corneal ulcer eventually became severe. Use of the bandage soft contact lens was discontinued. His antimicrobial agent was changed to cefmenoxime, a drug to which fluoroquinolone-resistant Corynebacterium is sensitive, and topical instillation of autologous serum subsequently promoted improvement of the ulcer. On day 38 after injury, iris rubeosis led to hyphema and ghost cell glaucoma. With improvement of his corneal epithelial defect, the iris rubeosis and hyphema regressed and his visual acuity improved to 20/25 on the left eye. To the best of our knowledge, this is the first report of a case resulting in severe complications due to chemical injury by a neutral detergent. Ophthalmologists should be aware that corneal epithelial damage may become prolonged in elderly patients with diabetes, and unexpectedly severe when wearing bandage soft contact lens, with infection of Corynebacterium resistant to fluoroquinolones, even if the chemical agent is a neutral detergent.
Collapse
Affiliation(s)
- Chikako Suto
- Department of Ophthalmology, Saiseikai Kurihashi Hospital, Kuki, Saitama ; Department of Ophthalmology, Tokyo Women's Medical University, Shinjuku, Tokyo
| | | | | |
Collapse
|
37
|
Schröder J, Maus I, Meyer K, Wördemann S, Blom J, Jaenicke S, Schneider J, Trost E, Tauch A. Complete genome sequence, lifestyle, and multi-drug resistance of the human pathogen Corynebacterium resistens DSM 45100 isolated from blood samples of a leukemia patient. BMC Genomics 2012; 13:141. [PMID: 22524407 PMCID: PMC3350403 DOI: 10.1186/1471-2164-13-141] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2011] [Accepted: 04/23/2012] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Corynebacterium resistens was initially recovered from human infections and recognized as a new coryneform species that is highly resistant to antimicrobial agents. Bacteremia associated with this organism in immunocompromised patients was rapidly fatal as standard minocycline therapies failed. C. resistens DSM 45100 was isolated from a blood culture of samples taken from a patient with acute myelocytic leukemia. The complete genome sequence of C. resistens DSM 45100 was determined by pyrosequencing to identify genes contributing to multi-drug resistance, virulence, and the lipophilic lifestyle of this newly described human pathogen. RESULTS The genome of C. resistens DSM 45100 consists of a circular chromosome of 2,601,311 bp in size and the 28,312-bp plasmid pJA144188. Metabolic analysis showed that the genome of C. resistens DSM 45100 lacks genes for typical sugar uptake systems, anaplerotic functions, and a fatty acid synthase, explaining the strict lipophilic lifestyle of this species. The genome encodes a broad spectrum of enzymes ensuring the availability of exogenous fatty acids for growth, including predicted virulence factors that probably contribute to fatty acid metabolism by damaging host tissue. C. resistens DSM 45100 is able to use external L-histidine as a combined carbon and nitrogen source, presumably as a result of adaptation to the hitherto unknown habitat on the human skin. Plasmid pJA144188 harbors several genes contributing to antibiotic resistance of C. resistens DSM 45100, including a tetracycline resistance region of the Tet W type known from Lactobacillus reuteri and Streptococcus suis. The tet(W) gene of pJA144188 was cloned in Corynebacterium glutamicum and was shown to confer high levels of resistance to tetracycline, doxycycline, and minocycline in vitro. CONCLUSIONS The detected gene repertoire of C. resistens DSM 45100 provides insights into the lipophilic lifestyle and virulence functions of this newly recognized pathogen. Plasmid pJA144188 revealed a modular architecture of gene regions that contribute to the multi-drug resistance of C. resistens DSM 45100. The tet(W) gene encoding a ribosomal protection protein is reported here for the first time in corynebacteria. Cloning of the tet(W) gene mediated resistance to second generation tetracyclines in C. glutamicum, indicating that it might be responsible for the failure of minocycline therapies in patients with C. resistens bacteremia.
Collapse
Affiliation(s)
- Jasmin Schröder
- Institut für Genomforschung und Systembiologie, Centrum für Biotechnologie, Universität Bielefeld, Germany
| | | | | | | | | | | | | | | | | |
Collapse
|
38
|
Suto C, Morinaga M, Yagi T, Tsuji C, Toshida H. Conjunctival sac bacterial flora isolated prior to cataract surgery. Infect Drug Resist 2012; 5:37-41. [PMID: 22294861 PMCID: PMC3269131 DOI: 10.2147/idr.s27937] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective To determine the trends of conjunctival sac bacterial flora isolated from patients prior to cataract surgery. Subjects and methods The study comprised 579 patients (579 eyes) who underwent cataract surgery. Specimens were collected by lightly rubbing the inferior palpebral conjunctival sac with a sterile cotton swab 2 weeks before surgery, and then cultured for isolation of bacteria and antimicrobial sensitivity testing. The bacterial isolates and percentage of drug-resistant isolates were compared among age groups and according to whether or not patients had diabetes mellitus, hyperlipidemia, dialysis therapy, oral steroid use, dry eye syndrome, or allergic conjunctivitis. Results The bacterial isolation rate was 39.2%. There were 191 strains of Gram-positive cocci, accounting for the majority of all isolates (67.0%), among which methicillin-sensitive coagulase-negative staphylococci was the most frequent (127 strains, 44.5%), followed by methicillin-resistant coagulase-negative staphylococci (37 strains, 12.7%). All 76 Gram-positive bacillary isolates (26.7%) were from the genus Corynebacterium. Among the 16 Gram-negative bacillary isolates (5.9%), the most frequent was Escherichia coli (1.0%). The bacterial isolation rate was higher in patients >60 years old, and was lower in patients with dry eye syndrome, patients under topical treatment for other ocular disorders, and patients with hyperlipidemia. There was no significant difference in bacterial isolation rate with respect to the presence/absence of diabetes mellitus, steroid therapy, dialysis, or a history of allergic conjunctivitis. Methicillin-resistant coagulase-negative staphylococci showed a significantly higher detection rate in diabetic patients than nondiabetic patients (20.3% versus 7.0%, P < 0.05). The percentage of all isolates resistant to levofloxacin, cefmenoxime, and tobramycin was 14.0%, 15.2%, and 17.9%, respectively, with no significant differences among these drugs. Conclusion The high bacterial isolation rate in patients >60 years old and the high methicillin-resistant coagulase-negative staphylococci isolation rate in patients with diabetes are important to consider for prevention of perioperative infections.
Collapse
Affiliation(s)
- Chikako Suto
- Department of Ophthalmology, Saiseikai Kurihashi Hospital, Saitama
| | | | | | | | | |
Collapse
|
39
|
Abstract
Bacterial infections of the eye are common and ophthalmologists are spoilt for choice with a variety of antibiotics available in the market. Antibiotics can be administered in the eye by a number of routes; topical, subconjunctival, subtenon and intraocular. Apart from a gamut of eye drops available, ophthalmologists also have the option of preparing fortified eye drops from parenteral formulations, thereby, achieving high concentrations; often much above the minimum inhibitory concentration (MIC), of antibiotics in ocular tissues during therapy. Antibiotic resistance among ocular pathogens is increasing in parallel with the increase seen over the years in bacteria associated with systemic infections. Although it is believed that the rise in resistant ocular bacterial isolates is linked to the rise in resistant systemic pathogens, recent evidence has correlated the emergence of resistant bacteria in the eye to prior topical antibiotic therapy. One would like to believe that either of these contributes to the emergence of resistance to antibiotics among ocular pathogens. Until recently, ocular pathogens resistant to fluoroquinolones have been minimal but the pattern is currently alarming. The new 8-fluoroquinolone on the scene-besifloxacin, is developed exclusively for ophthalmic use and it is hoped that it will escape the selective pressure for resistance because of lack of systemic use. In addition to development of new antibacterial agents, the strategies to halt or control further development of resistant ocular pathogens should always include judicious use of antibiotics in the treatment of human, animal or plant diseases.
Collapse
Affiliation(s)
- S Sharma
- Laboratory Services, LVPEI-Network, L V Prasad Eye Institute, Patia, Bhubaneswar, Orissa - 751 024, India.
| |
Collapse
|
40
|
Fukumoto A, Sotozono C, Hieda O, Kinoshita S. Infectious keratitis caused by fluoroquinolone-resistant Corynebacterium. Jpn J Ophthalmol 2011; 55:579-580. [PMID: 21717177 DOI: 10.1007/s10384-011-0052-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2010] [Accepted: 04/13/2011] [Indexed: 10/18/2022]
Affiliation(s)
- Akiko Fukumoto
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, 465 Hirokoji-agaru, Kawaramachi-dori, Kamigyo-ku, Kyoto, 602-0841, Japan
| | - Chie Sotozono
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, 465 Hirokoji-agaru, Kawaramachi-dori, Kamigyo-ku, Kyoto, 602-0841, Japan.
| | - Osamu Hieda
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, 465 Hirokoji-agaru, Kawaramachi-dori, Kamigyo-ku, Kyoto, 602-0841, Japan
| | - Shigeru Kinoshita
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, 465 Hirokoji-agaru, Kawaramachi-dori, Kamigyo-ku, Kyoto, 602-0841, Japan
| |
Collapse
|
41
|
Gallenga P, Del Boccio M, Rapinese M, Di Iorio A, Toniato E, Martinotti S. Molecular Approach by PCR is the Best Method to Detect the Presence of Chlamydia Trachomatis and to Define the True Agent of Ocular Bacterial Inflammation. Int J Immunopathol Pharmacol 2011; 24:285-96. [DOI: 10.1177/039463201102400202] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Chlamydia trachomatis (Ct) is an atypical agent for acute, subclinical and chronic conjunctivitis in developed countries, as stated by the International League against Trachoma. In order to evaluate the presence of Ct, from a total of 3,520 patients visiting the consulting room of the Eye Clinic of G. d'Annunzio University of Chieti, Italy from 2006–2008, we enrolled 171 patients affected by occasional mild, moderate or severe conjunctivitis in a three-arm prospective open study, using traditional analysis such as Immune Fluorescent Assay and Enzyme–Linked Fluorescent Assay (IFA and ELFA) and molecular analysis with Polymerase Chain Reaction (PCR) procedure for Ct DNA research (Ct DNA). At the same time, microbiological culture was carried out for common germs and mycetes. These patients were analyzed at different subsequent times. In the first arm (Group A) of 82 patients with IFA and ELFA only 10 people (12.2%) resulted positive to Ct infection with both methods. The presence of Ct was never alone, but always overlapped with contaminants, like corynebacteria, staphylococci, streptococci and colonbacteria, randomly distributed, while no growth of mycetes was observed. Of these positive patients, only one 47-year-old female, suffering from a moderate form of ocular chlamydial infection, showed serological conversion against this infection; furthermore, this female had also been suffering from reactive arthritis for sometime. In the second arm (Group B) of 89 patients, we carried out PCR for Ct detection: 82 (94.25%) were found positive to Ct – DNA research, with common germ growth randomly associated, without sex or age prevalence, as in group A; no mycetes were found. The third arm (Group C) included 37 negative patients from Group A with severe or moderate chronic conjunctivitis, randomly recruited between relapsing cases, with the addition of the single previously positive seroconversion case, for a total of 38 patients, who were re-evaluated by PCR Ct-DNA analysis. All these patients, negative to IFA and ELFA, were positive to Ct-DNA analysis. These data indicate a higher rate of Ct infection in patients with severe or moderate chronic conjunctivitis, resistant to usual therapies even after eradication of common germs, thus showing the advantage of introducing this molecular technique of analysis in mild to severe chronic or recurrent conjunctivitis.
Collapse
Affiliation(s)
- P.E. Gallenga
- Dept. Surgical Science Clinical Experimental, Section of Ophthalmology
| | - M. Del Boccio
- Dept. Surgical Science Clinical Experimental, Section of Ophthalmology
| | - M. Rapinese
- Dept. Surgical Science Clinical Experimental, Section of Ophthalmology
| | | | - E. Toniato
- Dept. of Oncology and Neuroscience Biomedical Sciences. Faculty of Medicine, “G. d'Annunzio” University Chieti-Pescara
| | - S. Martinotti
- Dept. of Oncology and Neuroscience Biomedical Sciences. Faculty of Medicine, “G. d'Annunzio” University Chieti-Pescara
| |
Collapse
|
42
|
Alsuwaidi AR, Wiebe D, Burdz T, Ng B, Reimer A, Singh C, Bernard K. Corynebacterium macginleyi conjunctivitis in Canada. J Clin Microbiol 2010; 48:3788-90. [PMID: 20702661 PMCID: PMC2953085 DOI: 10.1128/jcm.01289-10] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2010] [Revised: 06/29/2010] [Accepted: 07/30/2010] [Indexed: 11/20/2022] Open
Abstract
This report describes for the first time Corynebacterium macginleyi as a cause of conjunctivitis in Canada, where menaquinone analysis was done as part of the strain characterization. This species is typically isolated from ocular surfaces of patients from Europe and Japan. The isolate was resistant to erythromycin and clindamycin.
Collapse
Affiliation(s)
- Ahmed R Alsuwaidi
- United Arab Emirates University, Department of Paediatrics, Al Ain, United Arab Emirates
| | | | | | | | | | | | | |
Collapse
|
43
|
Peterson JW, Moen ST, Healy D, Pawlik JE, Taormina J, Hardcastle J, Thomas JM, Lawrence WS, Ponce C, Chatuev BM, Gnade BT, Foltz SM, Agar SL, Sha J, Klimpel GR, Kirtley ML, Eaves-Pyles T, Chopra AK. Protection Afforded by Fluoroquinolones in Animal Models of Respiratory Infections with Bacillus anthracis, Yersinia pestis, and Francisella tularensis. Open Microbiol J 2010; 4:34-46. [PMID: 21127743 PMCID: PMC2995158 DOI: 10.2174/1874285801004010034] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2010] [Revised: 04/19/2010] [Accepted: 04/23/2010] [Indexed: 11/28/2022] Open
Abstract
Successful treatment of inhalation anthrax, pneumonic plague and tularemia can be achieved with fluoroquinolone antibiotics, such as ciprofloxacin and levofloxacin, and initiation of treatment is most effective when administered as soon as possible following exposure. Bacillus anthracis Ames, Yersinia pestis CO92, and Francisella tularensis SCHU S4 have equivalent susceptibility in vitro to ciprofloxacin and levofloxacin (minimal inhibitory concentration is 0.03 μg/ml); however, limited information is available regarding in vivo susceptibility of these infectious agents to the fluoroquinolone antibiotics in small animal models. Mice, guinea pig, and rabbit models have been developed to evaluate the protective efficacy of antibiotic therapy against these life-threatening infections. Our results indicated that doses of ciprofloxacin and levofloxacin required to protect mice against inhalation anthrax were approximately 18-fold higher than the doses of levofloxacin required to protect against pneumonic plague and tularemia. Further, the critical period following aerosol exposure of mice to either B. anthracis spores or Y. pestis was 24 h, while mice challenged with F. tularensis could be effectively protected when treatment was delayed for as long as 72 h postchallenge. In addition, it was apparent that prolonged antibiotic treatment was important in the effective treatment of inhalation anthrax in mice, but short-term treatment of mice with pneumonic plague or tularemia infections were usually successful. These results provide effective antibiotic dosages in mice, guinea pigs, and rabbits and lay the foundation for the development and evaluation of combinational treatment modalities.
Collapse
Affiliation(s)
- Johnny W Peterson
- Department of Microbiology and Immunology, Galveston National Laboratory, University of Texas Medical Branch, 301 University Blvd. Galveston, Texas 77555-0610
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
44
|
Ruoff KL, Toutain-Kidd CM, Srinivasan M, Lalitha P, Acharya NR, Zegans ME, Schwartzman JD. Corynebacterium macginleyi isolated from a corneal ulcer. Infect Dis Rep 2010; 2:1568. [PMID: 21709740 PMCID: PMC3123035 DOI: 10.4081/idr.2010.e3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2009] [Revised: 02/08/2010] [Accepted: 02/08/2010] [Indexed: 11/25/2022] Open
Abstract
We report the isolation of Corynebacterium macginleyi from the corneal ulcer culture of a patient, later enrolled in the Steroids for Corneal Ulcer Trial (SCUT). To our knowledge this is the first published report from North America of the recovery of C. macginleyi from a serious ocular infection.
Collapse
Affiliation(s)
- Kathryn L. Ruoff
- Department of Pathology, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
| | - Christine M. Toutain-Kidd
- Department of Surgery (section of Ophthalmology), Dartmouth Medical School, Hanover, NH, USA, and Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
| | | | | | - Nisha R. Acharya
- F.I. Proctor Foundation, University of California, San Francisco, CA, USA
- Department of Ophthalmology, University of California, San Francisco, CA, USA
| | - Michael E. Zegans
- Department of Surgery (section of Ophthalmology), Dartmouth Medical School, Hanover, NH, USA, and Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
| | | |
Collapse
|
45
|
Radaelli E, Manarolla G, Pisoni G, Balloi A, Aresu L, Sparaciari P, Maggi A, Caniatti M, Scanziani E. Suppurative adenitis of preputial glands associated with Corynebacterium mastitidis infection in mice. JOURNAL OF THE AMERICAN ASSOCIATION FOR LABORATORY ANIMAL SCIENCE : JAALAS 2010; 49:69-74. [PMID: 20122320 PMCID: PMC2824971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/30/2009] [Revised: 08/03/2009] [Accepted: 08/24/2009] [Indexed: 05/28/2023]
Abstract
Suppuration of the preputial gland in mice occurs as a septic complication of fight wounds around the external genitalia. Currently reported bacterial isolates from these lesions are limited to Staphylococcus aureus, Pasteurella pneumotropica, and Klebsiella oxytoca. In the context of a pilot experiment aimed at defining the aging phenotype of estrogen receptor beta knockout (BERKO) mice, 2 male mice (1 of the BERKO line and the other from the age- and sex-matched wild-type control group) were discovered at necropsy to have preputial gland lesions. In both cases, histopathologic examination confirmed severe suppuration and abscesses of the preputial glands associated with systemic reactive (secondary) amyloidosis. Both Gram staining and Bacillus Calmette-Guérin immunohistochemistry highlighted the presence of numerous bacillary to rod-shaped bacteria within the preputial lesions. Subsequent PCR analysis coupled with denaturing gradient gel electrophoresis identified Corynebacterium mastitidis in the preputial gland abscesses. This organism is isolated infrequently from the milk of sheep with subclinical mastitis and was identified as part of the normal microflora of the human ocular surface. No information regarding the epidemiology and pathogenesis of C. mastitidis infection in laboratory animals is currently available, and to our knowledge this report is the first description of C. mastitidis infection in mice.
Collapse
Affiliation(s)
- Enrico Radaelli
- Department of Veterinary Pathology, Hygiene, and Public Health, Faculty of Veterinary Medicine, Università degli Studi di Milano, Milan, Italy.
| | | | | | | | | | | | | | | | | |
Collapse
|
46
|
|