Clinical Characteristics of Stenotrophomonas maltophilia Keratitis.
OBJECTIVE
Stenotrophomonas maltophilia is an important opportunistic pathogen but an uncommon cause of corneal infections. This study aimed to report the clinical features, antibiotic susceptibility, treatments, and visual outcomes of S. maltophilia keratitis.


METHODS
The medical records of 21 patients with culture-proven S. maltophilia-associated infectious keratitis in our hospital between January 1, 2003, and December 31, 2014, were retrospectively reviewed. The clinical features of patients with S. maltophilia keratitis were compared with those of patients from 17 previously reported cases.


RESULTS
The most common risk factors for S. maltophilia keratitis were preexisting corneal disease or previous corneal surgery (16), followed by soft contact lens wear (9). Nine patients (42.9%) were multifactorial. Polymicrobial infections was detected in 12 eyes (57.1%). All S. maltophilia isolates were susceptible to levofloxacin and moxifloxacin. A total of 17 of 21 patients (81.0%) had favorable responses to topical antimicrobial treatment, and 10 (47.6%) required surgical intervention for promotion of reepithelialization (6) and corneal perforation (4). Final vision ranged from light perception to 20/20. The clinical features of S. maltophilia keratitis in our cases and in previously reported cases were similar.


CONCLUSIONS
S. maltophilia keratitis primarily affects patients with compromised ocular surfaces. S. maltophilia demonstrates in vitro susceptibility and a strong clinical response to fluoroquinolones.
*Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taiwan; †College of Medicine, Chang Gung University, Taoyuan, Taiwan; and ‡Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung, Taiwan.
An-Lun
AL
Wu
Lung-Kun
LK
Yeh
David H K
DH
Ma
Phil Y F
PY
Chen
Hsin-Chiung
HC
Lin
Chi-Chin
CC
Sun
Hsin-Yuan
HY
Tan
Hung-Chi
HC
Chen
Shin-Yi
SY
Chen
Ching-Hsi
CH
Hsiao
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003320:Corneal Ulcer / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D015818:Eye Infections, Bacterial / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D005260:Female; D024841:Fluoroquinolones / Q000627:therapeutic use; D016905:Gram-Negative Bacterial Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D020615:Stenotrophomonas maltophilia / Q000187:drug effects / Q000302:isolation & purification*; D014792:Visual Acuity / Q000502:physiology
D000900:Anti-Bacterial Agents; D024841:Fluoroquinolones