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    ARMOR surveillance study update gives current insights on antibiotic resistance for clinical ocular isolates


    Time trends

    Because staphylococci are common causative pathogens in ophthalmic infections and considering evidence of high rates of antibiotic resistance among these organisms, a time-trend analysis was also performed to examine changes in resistance of S. aureus and CoNS isolates during the 8 years since ARMOR began. The analysis included data for 1597 S. aureus isolates and 1400 CoNS isolates submitted to ARMOR between January 2009 and October 2016.

    The results showed that the overall rate of methicillin resistance among S. aureus isolates decreased significantly over time, falling from 39% in 2009 to 27% during the first 10 months of 2016. There was no decrease in the rate of methicillin resistance among CoNS isolates, and almost half of CoNS were methicillin-resistant in 2016.

    Focusing on data for S. aureus isolates, the trend analysis showed significant decreases in rates of resistance from 2009 to 2016 for azithromycin (62% to 47%), ciprofloxacin (39% to 25%), and tobramycin (24% to 9%). Among CoNS isolates, resistance to ciprofloxacin also decreased significantly over the 8-year time period, from 46% in 2009 to 30% in 2016, but CoNS resistance to trimethroprim increased significantly from 26% to 37%.

    Commenting on the findings of the trend analysis, Dr. Asbell told Ophthalmology Times, “Over the course of 8 years of ARMOR, staphylococci have consistently shown the highest resistance rates among the species tested.  In recent years, there has been a plateau of resistance rates, and they may be decreasing at present.  Indeed, the decreases in resistance observed among S. aureus to methicillin, macrolides, fluoroquinolones and aminoglycosides, are promising findings that may reflect improved antibiotic stewardship and an awareness of the challenges antibiotic resistance impose on patient health.” 

    “However, since resistance remains high among CoNS, with no change in methicillin resistance and an increase in trimethoprim resistance, increased efforts by ophthalmologists to limit overprescribing, cycle between antibiotic classes, avoid prolonged treatment regimens, and emphasize patient dosing compliance are warranted.”



    Penny Asbell, MD

    E: [email protected]

    ARMOR updates were presented at the 2017 meeting of the Association for Research in Vision and Ophthalmology. Dr. Asbell is a consultant to Bausch + Lomb.

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