title: Clinical Characteristics and Bacteriological Profile of Moraxella Keratitis.
abstract: OBJECTIVE
  Moraxella species are rare causative pathogens of severe sight-threatening keratitis. The aim of this study was to analyze the clinical presentation, predisposing risk factors, in vitro antimicrobial susceptibility, and treatment associated with Moraxella keratitis.
  
  
  METHODS
  We retrospectively reviewed 30 culture-proven cases of Moraxella keratitis from multiple centers in Japan.
  
  
  RESULTS
  The mean age of the patients was 58.4 ± 23.4 years. The most common ocular conditions were contact lens wearing (5 patients, 16.7%) and trauma (3 patients, 10.0%). Seven patients had diabetes mellitus. Sixteen patients exhibited hypopyon in association with the corneal focus. Ring-shaped infiltration was found in 9 patients (30.0%), and irregular or amoebic-shaped infiltration was observed in 13 patients (43.3%). Eight patients (26.7%) showed small round infiltrates. All Moraxella isolates were sensitive to fluoroquinolones and aminoglycosides. All were treated with a combination ophthalmic solution containing a fluoroquinolone, tobramycin, and cefmenoxime. Although no patients developed corneal perforation, the response to treatment was slow in all cases; the mean treatment period was 41.9 days.
  
  
  CONCLUSIONS
  In Japan, Moraxella keratitis occurs in patients with contact lens wear, trauma, and diabetes mellitus. It presents as a small, round, ring-shaped, irregularly shaped, or amoebic-shaped focus. Moraxella species exhibit good susceptibility to fluoroquinolones and aminoglycosides. Because the treatment response may be very slow, these agents should be continued for a long period of time.
authors.affiliation: *OMIC (Ocular Microbiology and Infection Conference) Working Group; †Department of Ophthalmology, Ehime University Graduate School of Medicine, Toon, Japan; ‡Department of Ophthalmology, Tokyo Medical University, Tokyo, Japan; §Miyata Eye Hospital, Miyakonojo, Japan; ¶Department of Ophthalmology, Gunma University School of Medicine, Maebashi, Japan; ‖Department of Ophthalmology, National Center for Geriatrics and Gerontology, Obu, Japan; **Department of Ophthalmology, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan; and ††Department of Clinical Laboratory, Ehime University Hospital, Toon, Japan.
authors.forename: Hidenori
authors.initials: H
authors.lastname: Inoue
authors.forename: Takashi
authors.initials: T
authors.lastname: Suzuki
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Inoue
authors.forename: Takaaki
authors.initials: T
authors.lastname: Hattori
authors.forename: Ryohei
authors.initials: R
authors.lastname: Nejima
authors.forename: Daisuke
authors.initials: D
authors.lastname: Todokoro
authors.forename: Saichi
authors.initials: S
authors.lastname: Hoshi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Eguchi
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Miyamoto
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Ohashi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D015281:Cefmenoxime / Q000627:therapeutic use; D002648:Child; D003261:Contact Lenses / Q000009:adverse effects; D003320:Corneal Ulcer / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D004359:Drug Therapy, Combination; D015818:Eye Infections, Bacterial / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D005131:Eye Injuries / Q000150:complications; D005260:Female; D024841:Fluoroquinolones / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009016:Moraxella / Q000302:isolation & purification*; D045828:Moraxellaceae Infections / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D012189:Retrospective Studies; D012307:Risk Factors; D014031:Tobramycin / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D024841:Fluoroquinolones; D015281:Cefmenoxime; D014031:Tobramycin