Clinical, microbiological profile and treatment outcome of ocular infections caused by Achromobacter xylosoxidans.
OBJECTIVE
To study the microbiological profile and outcome of ocular infections caused by Achromobacter xylosoxidans.


METHODS
Medical and microbiology records of patients with A. xylosoxidans ocular infections managed between May 2007 and December 2007 were reviewed.


RESULTS
The authors identified 10 patients whose eyes were infected by A. xylosoxidans during the study period. Of 10 patients, 8 had microbial keratitis, of whom 6 developed an infection after penetrating keratoplasty. The remaining 2 patients had endophthalmitis. The Gram-stained smear did not reveal any organism in 6 of 10 cases. In the 4 remaining cases, Gram-negative bacilli were reported. Out of 10 isolates, 9 were sensitive to ceftazidime, 7 to amikacin, 5 to ciprofloxacin, and 3 to ofloxacin, gatifloxacin, and chloramphenicol. Only one isolate was sensitive to moxifloxacin. Of the 6 patients with graft infection, 2 patients were lost to follow-up, infection was resolved in 3 patients, and the infection remained active in 1 patient. The two patients with endophthalmitis responded to antibacterial therapy and showed improved visual acuity. Infection was resolved in 2 patients with keratitis.


CONCLUSIONS
Although A. xylosoxidans ocular infections are rare, one should retain a high index of clinical suspicion in patients who present with slowly progressive disease characterized by a localized infiltration and show Gram-negative bacilli on smear examination.
Reddy
Ashok Kumar
AK
Jhaveri Microbiology Centre, Hyderabad Eye Research Foundation, India. ashokkumar@lvpei.org
Garg
Prashant
P
Shah
Vishal
V
Gopinathan
Usha
U
D042441:Achromobacter denitrificans; D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002675:Child, Preschool; D009877:Endophthalmitis / Q000382:microbiology / Q000503:physiopathology; D015818:Eye Infections, Bacterial / Q000188:drug therapy / Q000209:etiology; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy / Q000209:etiology; D006801:Humans; D007634:Keratitis / Q000382:microbiology; D015948:Keratoplasty, Penetrating / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D014792:Visual Acuity / Q000187:drug effects; D055815:Young Adult
D000900:Anti-Bacterial Agents