Fluoroquinolone resistance in bacterial isolates from ocular infections: Trend in antibiotic susceptibility patterns between 2005-2020.

Abstract

Purpose:

To assess the fluoroquinolone resistance pattern and trends among bacterial isolates from ocular infections over a 16-year period and explore alternative antibiotics in fluoroquinolone-resistant strains.

Methods:

In this retrospective, longitudinal study, the microbiology laboratory records of patients with different ocular infections diagnosed at an eye institute in central India from 2005-2020 were reviewed to determine the pattern of fluoroquinolone (ciprofloxacin, ofloxacin, gatifloxacin, and moxifloxacin) resistance. Antibiotic susceptibility testing was done using the Kirby-Bauer disc diffusion method.

Results:

In 725 Gram-positive bacteria, the resistance of ciprofloxacin, ofloxacin, gatifloxacin, and moxifloxacin was 55.9% (95% confidence interval [CI]: 52.2 - 59.6), 42.7% (95% CI: 39.0 - 46.4), 47.6% (95% CI: 43.9 - 51.3), and 45.6% (95% CI: 41.7-49.5), respectively. In 266 Gram-negative bacteria, the resistance of ciprofloxacin, ofloxacin, gatifloxacin, and moxifloxacin was 57.9% (95% CI: 51.9 - 63.9), 56.0% (95% CI: 49.7 - 62.1), 59.9% (95% CI: 53.8 - 66.0), and 74.3% (95% CI: 68.3 - 80.2), respectively. A declining trend in resistance to ciprofloxacin (P < 0.001), ofloxacin (P < 0.001), and moxifloxacin (P < 0.001) was seen in Gram-positive bacteria, whereas a reduction in resistance to only moxifloxacin (P = 0.04) was seen in Gram-negative bacteria. In fluoroquinolone-resistant Gram-positive bacteria, cefuroxime exhibited the highest susceptibility, whereas in fluoroquinolone-resistant Gram-negative bacteria, colistin exhibited the highest susceptibility.

Conclusion:

Fluoroquinolone resistance was high among bacteria from ocular infections in central India, but a declining trend in resistance to some of the fluoroquinolones was observed in recent times. Cefuroxime and colistin emerged as alternatives in fluoroquinolone-resistant Gram-positive and Gram-negative bacterial infections, respectively.

• Authors: Samrat Chatterjee, Deepshikha Agrawal, Sharad N Gomase, Swapnil M Parchand, Anil B Gangwe, Mihir Mishra
• Journal: Indian journal of ophthalmology (Indian J Ophthalmol) Vol. 70 Issue 12 Pg. 4391-4398 (12 2022) ISSN: 1998-3689 [Electronic] India
• PMID: 36453351 (Publication Type: Journal Article)

Chemical References

• Fluoroquinolones
• Moxifloxacin
• Gatifloxacin
• Cefuroxime
• Colistin
• Ciprofloxacin
• Ofloxacin
• Anti-Bacterial Agents

Topics

• Humans
• Fluoroquinolones (pharmacology)
• Moxifloxacin
• Gatifloxacin
• Cefuroxime
• Colistin
• Longitudinal Studies
• Retrospective Studies
• Ciprofloxacin
• Ofloxacin
• Eye Infections
• Anti-Bacterial Agents (pharmacology)