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Abstract
Purpose
To investigate the clinical features and treatment outcomes between methicillin-sensitive Staphylococcus epidermidis (MSSE) and methicillin-resistant Staphylococcus epidermidis (MRSE) keratitis groups.
Methods
A retrospective analysis of case series was conducted of all patients with keratitis caused only by Staphylococcus epidermidis from January 1997 through December 2008. Sex, age, history of trauma, systemic disease, previous ocular history, antibiotic sensitivity test results, and treatment outcomes were evaluated. Patients were categorized into two groups as MSSE and MRSE according to methicillin-sensitivity result, and a comparative analysis was performed.
Results
There were no significant differences in clinical features, such as risk factors or size or location of keratitis between the two groups. All MSSE and MRSE isolates were sensitive to vancomycin, moxifloxacin, and levofloxacin. All MSSE and 17%, 50%, 52%, and 57% of MRSE isolates were sensitive to cephalothin, norfloxacin, ciprofloxacin, and erythromycin, respectively (p < 0.05). There was no significant difference in visual acuity between the two groups.
Conclusions
All MSSE and MRSE isolates were sensitive to vancomycin and to third- or fourth-generation fluoroquinolones In addition, approximately 50% of MRSE isolates were sensitive to norfloxacin and ciprofloxacin. There were no significant differences in clinical features of keratitis caused by MSSE versus those of MRSE isolates. Both keratitis groups had relatively good visual prognoses.
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Figure 1.
Antibiotic sensitivity in patients with Staphylococcus epidermidis keratitis (%). MSSE = methicillin-sensitive Staphylococcus epidermidis; MRSE = methicillin-resistant Staphylococcus epidermidis. * p-value < 0.05.
Table 1.
Demographics and patient characteristics in patients with Staphylococcus epidermidis keratitis
Table 2.
Predisposing factors in patients with Staphylococcus epidermidis keratitis
Table 3.
Clinical manifestations in patients with Staphylococcus epidermidis keratitis
Table 4.
Results of treatment for keratitis caused by Staphylococcus epidermidis
| Result | MSSE group | MRSE group | p-value |
|---|---|---|---|
| Recovery | 12 (60%) | 16 (70%) | 0.512 |
| Treatment failure | 4 (20%) | 5 (22%) | 0.889 |
| No follow-up | 4 (20%) | 2 (8%) | 0.286 |
| Total | 20 | 23 | |
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