Open AccessAntibiotic resistance among bacterial conjunctival pathogens collected in the Antibiotic Resistance Monitoring in Ocular Microorganisms (ARMOR) surveillance study
Author(s) -
Penny A. Asbell,
Heleen H DeCory
Publication year - 2018
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0205814
Subject(s) - microbiology and biotechnology , streptococcus pneumoniae , ciprofloxacin , antibiotic resistance , haemophilus influenzae , staphylococcus aureus , antibiotics , pseudomonas aeruginosa , tobramycin , azithromycin , drug resistance , medicine , methicillin resistant staphylococcus aureus , biology , gentamicin , bacteria , genetics
The Antibiotic Resistance Monitoring in Ocular Microorganisms (ARMOR) surveillance study evaluates in vitro antibiotic resistance among Staphylococcus aureus , coagulase-negative staphylococci (CoNS), Streptococcus pneumoniae , Pseudomonas aeruginosa , and Haemophilus influenzae isolates from ocular infections. Here we report resistance rates and trends among conjunctival-sourced ocular isolates collected across the US from 2009 through 2016. A total of 1198 conjunctival isolates (483 S . aureus , 305 CoNS, 208 H . influenzae , 118 S . pneumoniae , and 84 P . aeruginosa) were collected from patients with presumed bacterial conjunctivitis from 57 sites across 40 states. A large proportion of staphylococci demonstrated resistance to oxacillin and azithromycin, while resistance was low against the majority of antibiotics tested for S . pneumoniae , P . aeruginosa , and H . influenzae . Multidrug resistance (≥3 antibiotic classes) was found in 30.2% of S . aureus and 39.0% of CoNS isolates, and methicillin resistance more than doubled the rate of multi-drug resistance (methicillin-resistant S . aureus [MRSA], 76.5%; methicillin-resistant CoNS isolates, 72.8%). There was a pattern of increasing mean percent resistance with increasing age by decade of life among S . aureus , MRSA, and CoNS ( P ≤0.038). Over the eight-year study period, there were small yet significant decreases in resistance rates among S . aureus to azithromycin, ciprofloxacin, tobramycin, trimethoprim, and oxacillin ( P≤ 0.003), and among CoNS and P . aeruginosa (both P <0.05) to ciprofloxacin. These data indicate that antibiotic resistance is high, but did not increase, among conjunctival-sourced isolates collected in the US from 2009 through 2016. For certain antibiotic/pathogen combinations, there was a trend of decreased resistance, including a decrease in oxacillin resistance among S . aureus .