Methicillin-resistant Staphylococcus epidermidis infectious keratitis: Clinical and microbiological profile

Abstract

Introduction. Staphylococcus epidermidis (SE) is a common cause of bacterial keratitis in certain geographic areas. A high percentage of resistance to methicillin is shown, which gives it cross resistance to beta-lactams and sometimes resistance to other antibacterial groups. We analyzed clinical and microbiological variables in patients with infectious keratitis due to SE. Methods. Medical records of 43 patients with suspected infectious keratitis and microbiological confirmation for SE, between October 2017 and October 2020, were retrospectively studied. Clinical characteristics (risk factors, size of lesions, treatment, evolution) and microbiological (susceptibility to antibiotics) were analyzed, and groups of patients with methicillin-resistant (MRSE) and methicillin-susceptible (MSSE) infection were compared. Results. MRSE was present in 37.2% of infectious keratitis. All isolates were sensitive to vancomycin and linezolid. Rates of resistance to tetracyclines and ciprofloxacin were 50% and 56% in the MRSE group, and 11% and 7% in the MSSE group. The clinical characteristics, including size of lesion, visual axis involvement, inflammation of anterior chamber, presence of risk factors and follow-up time, did not show statistically significant differences between groups. Conclusions. MRSE is a common cause of infectious keratitis caused by SE and shows a high rate of multidrug resistance. Clinically, it does not differ from MSSE keratitis. Additional work is needed to confirm these findings.