Ocular infections caused by non-tuberculous mycobacteria: Update on epidemiology and management

Dalia O. Girgis, Carol L. Karp, Darlene Miller

Research output: Contribution to journalReview articlepeer-review

36 Scopus citations

Abstract

Background: To provide an update on the frequency, distribution, risk factors and in vitro susceptibility of ocular infections caused by non-tuberculous mycobacteria. Design: Retrospective study of university clinic patients. Participants: One hundred thirty-nine patients with culture confirmed non-tuberculous mycobacteria infections seen at Bascom Palmer Eye Institute from January 1980 to July 2007. Methods: Chart review of data collected included patients' demographics, risk factors, microbiological profiles and clinical outcomes. Main Outcome Measures: Frequency, distribution, risk factors and in vitro susceptibility of ocular infections caused by non-tuberculous mycobacteria. Results: A total of 183 non-tuberculous mycobacteria isolates from 142 eyes were identified, with a fourfold increase in the number of eyes infected with non-tuberculous mycobacteria from 1980-1989 (13.4%) to 2000-2007 (56.3%). Eighty-three percent of non-tuberculous mycobacteria isolates were identified as M.abscessus/chelonae. The majority (91%) of isolates were recovered within 10days. Common diagnoses included keratitis (36.6%), scleral buckle infections (14.8%) and socket/implant infections (14.8%). Identifiable risk factors were presence of biomaterials (63.1%), ocular surgery (24.1%) and steroid exposure (77%). The median time from diagnosis of culture positive non-tuberculous mycobacteria infection to resolution was 13 to 24weeks. Combination therapy was used to treat 80% of infected eyes. In vitro susceptibility of non-tuberculous mycobacteria isolates were: amikacin, 81%; clarithromycin, 93%; and moxifloxacin, 21%. Conclusions: The incidence of ocular infections caused by non-tuberculous mycobacteria has increased within the last 8years, with a high number of biomaterial associated infections among this group. Clinical diagnosis and microbiological confirmation of non-tuberculous mycobacteria infections remains challenging. Patient outcomes may be improved by early diagnosis, appropriate therapy and removal of biomaterials.

Original languageEnglish (US)
Pages (from-to)467-475
Number of pages9
JournalClinical and Experimental Ophthalmology
Volume40
Issue number5
DOIs
StatePublished - Jan 1 2012

Keywords

  • Antibiotic
  • Bacterial disease
  • Eye
  • Fluoroquinolone
  • Infection

ASJC Scopus subject areas

  • Pharmacology
  • Drug Discovery
  • Business and International Management
  • Applied Mathematics
  • Ophthalmology

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