Multi-Drug Resistant Pseudomonas Keratitis Clinical
Characteristics and Associated Features Jayesh Vazirani Merle
Fernandes L V Prasad Eye Institute Visakhapatnam, India Jayesh
Vazirani Merle Fernandes L V Prasad Eye Institute Visakhapatnam,
India The authors have no financial interests to disclose
Slide 2
Purpose To study Clinical characteristics Risk factors For
Multi-Drug Resistant (MDR) Pseudomonas aeruginosa keratitis
Slide 3
Methods Case Control study design (2007-2014) Definitions
Pseudomonas aeruginosa keratitis Clinical features of microbial
keratitis Significant growth (two solid media / one solid and one
liquid medium / correlation between smear and culture) of
Pseudomonas aeruginosa on culture from corneal scrapings Multi-drug
resistance Resistance to 3 or more classes of antimicrobial drugs,
as tested by Kirby-Bauer disc diffusion method
Slide 4
Methods Inclusion criteria: Cases - MDR Pseudomonas keratitis
Controls - Drug sensitive Pseudomonas keratitis Baseline
characteristics studied Age, gender, duration of symptoms, topical
medication used prior to presentation, trauma, contact lens use,
ocular surface disease, prior ocular surgery A multivariate
logistic-regression model with stepwise elimination using Akaike
information criteria (AIC) was used to assess the association of
Cases and Controls with baseline characteristics Clinical course
and outcomes also compared
Slide 5
Results MDR Pseudomonas keratitis Drug Sensitive Pseudomonas
keratitis No of episodes 2367 No of eyes 2067 No of patients 1767
Bilateral cases 30 Median Age (years) 5449 % Male 52.9467.16 Graft
infiltrates (%) 9 (39.13)21 (31.34) Median duration of symptoms
(days) 74
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Results MDR Pseudomonas keratitis Drug Sensitive Pseudomonas
keratitis Topical Steroid use (%) 12 (52.17)23 (32.32) Lubricant
ointment use (%) 18 (78.26)26 (38.80) Trauma (%) 2 (10)8 (11.94)
Surgery (%) 11 (55)22 (32.83) Ocular surface disease (%) 18 (90)24
(35.82) Contact lens use (%) 5 (25)5 (7.46) Median Lesion size (mm)
85.4
Slide 7
Univariate Analysis p values
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Multivariate Analysis p values
Slide 9
Association with Multi-Drug Resistance Multivariate Odds Ratio
95% Confidence Intervals p Value Contact lens use 11.14(1.31
94.43)0.027 Ocular surface disease 37.29(3.89 357.2)0.002 Lubricant
ointment use 7.65(1.57 37.2)0.012 Univariate Odds Ratio 95%
Confidence Intervals p Value Contact lens use3.44(0.9 - 13.23)0.072
Ocular surface disease 18.81(4.06 87.21)