Contact lens-associated microbial keratitis.
OBJECTIVE
Contact lens-associated microbial keratitis is a severe condition with sight-threatening potential and increasing incidence. Information regarding the etiological agents is essential in guiding management and may vary geographically. The aim of this study was to analyze the microbiological results of corneal scrapings collected from patients presenting with contact lens-associated microbial keratitis.


METHODS
Retrospective analysis of the records of all patients who were clinically diagnosed with contact lens-associated microbial keratitis and had corneal scrapings sent to the Laboratory of Ocular Microbiology, UNIFESP/EPM during a 5-year period from January 2002 to December 2007.


RESULTS
The etiological agent was identified in 239 patients. Bacterial isolates accounted for 166 (69.46%) cases, Acanthamoeba for 95 (39.75%) cases and fungi for 4 (1.67%) cases. Among the bacterial infections, coagulase-negative Staphylococcus was demonstrated in 74 cases, while Pseudomonas spp was found in 32 patients. All coagulase negative Staphylococcus and Pseudomonas were susceptible to ciprofloxacin and ofloxacin. Resistance to gentamicin was documented in a single case of Pseudomonas. Fourth-generation flouoroquinolone resistance was not observed among Pseudomonas cases.


CONCLUSIONS
Coagulase-negative Staphylococcus was the most frequent isolate, and such data must be considered when determining empiric treatment. Second-generation fluoroquinolones ciprofloxacin and ofloxacin and fourth-generation fluoroquinolones moxifloxacin and gatifloxacin showed a good antibacterial profile and therefore could be good options for initial management.
Moriyama
Aline Silveira
AS
Department of Ophthalmology, Universidade Federal de São Paulo, São Paulo, SP, Brazil. aline_moriyama@yahoo.com
Hofling-Lima
Ana Luisa
AL
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000145:classification / Q000494:pharmacology; D002648:Child; D003261:Contact Lenses / Q000009:adverse effects / Q000382:microbiology*; D024881:Drug Resistance, Bacterial; D015818:Eye Infections, Bacterial / Q000188:drug therapy / Q000382:microbiology*; D005260:Female; D024841:Fluoroquinolones / Q000145:classification / Q000494:pharmacology; D006801:Humans; D007634:Keratitis / Q000188:drug therapy / Q000382:microbiology*; D008297:Male; D008875:Middle Aged; D011549:Pseudomonas / Q000187:drug effects / Q000254:growth & development; D012189:Retrospective Studies; D013210:Staphylococcus / Q000187:drug effects / Q000254:growth & development; D055815:Young Adult
D000900:Anti-Bacterial Agents; D024841:Fluoroquinolones