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    Antibiotic resistance in the eyecare practice

     

    Another perspective

    Perhaps we got it all wrong. One expert opines we should take the bacterium’s point of view. Actually, by numerical count, 90 percent of the cells in our bodies are bacteria. There are an estimated 100 trillion bacterial cells in your gut.15 The bacteria need to develop resistance just to survive. And sometimes bacteria have a reason to hurt you. One example is surgery—the first thing that happens is placing the patient on an IV drip. The drip deprives bacteria of their nutrients. Their sustenance is disappearing and causes a general panic. The bacteria become defensive, speed up reproduction and gene acquisition, and produce toxins that makes their host even sicker. Resistance is part of their natural process.15

    Do your part to help prevent antibiotic resistance

    Antibiotic resistance is real. Practitioners should maintain a level of suspicion for resistant organisms, especially in more aggressive infections or those lacking improvement with standard therapies. Consider antibiotic usage only when necessary and in concert with local antibiograms. (An antibiogram is an overall profile of antimicrobial susceptibility testing results of a specific microorganism to a battery of antimicrobial drug). Finally, carefully consider antibiotic selection based on the patient’s medical history and previous antibiotic exposure.

    References

    1.Fox News. Deadly superbug arrives in US, report says. Available at: http://www.foxnews.com/health/2016/05/27/deadly-superbug-arrives-in-us-report-says.html. Accessed 8/27/16.

    2. Baron S, editor. Medical Microbiology. 4th edition. Galveston (TX): University of Texas Medical Branch at Galveston; 1996. Available at: http://www.ncbi.nlm.nih.gov/books/NBK7627/. Accessed 8/27/16.

    3. National Institutes of Health. National Institute of Allergy and Infectious Diseases. Methicillin-Resistant Staphylococcus aureus (MRSA. Available at: https://www.niaid.nih.gov/topics/antimicrobialresistance/examples/mrsa/Pages/history.aspx. Accessed 8/27/16.

    4. Lowy FD. Antimicrobial resistance: the example of Staphylococcus aureus. J Clin Invest. 2003 May;111(9):1265-73.

    5. Centers for Disease Control and Prevention. About Antimicrobial Resistance. Available at: https://www.cdc.gov/drugresistance/about.html. Accessed 8/27/16.

    6. World Health Organization. Global Antimicrobial Resistance Surveillance System (GLASS). Available at: http://www.who.int/antimicrobial-resistance/global-action-plan/surveillance/glass/en/. Accessed 8/27/16.

    7. Vazirani J, Wurity S, Ali MH. Multidrug-Resistant Pseudomonas aeruginosa Keratitis: Risk Factors, Clinical Characteristics, and Outcomes.

    Ophthalmology. 2015 Oct;122(10):2110-4

    8. Mohammadpour M, Mohajernezhadfard Z, Khodabande A, Vahedi P. Antibiotic Susceptibility Patterns of Pseudomonas Corneal Ulcers in Contact Lens Wearers. Middle East Afr J Ophthalmol. 2011 Jul-Sep; 18(3):228-231.

    9. Chatterjee S, Agrawal D.Multi-drug resistant Pseudomonas aeruginosa keratitis and its effective treatment with topical colistimethate. Indian J Ophthalmol. 2016 Feb; 64(2): 153-157.

    10. Seo MH, Na YH, Lee DH, Kim JH. A Case of Successful Treatment Using Topical Colistin in Multidrug-resistant Pseudomonas aeruginosa Bacterial Ulcer. J Korean Ophthalmol Soc. 2016 Aug;57(8):1307-1311.  

    11. Asbell PA, Sanfilippo CM, Pillar CM, DeCory HH, Sahm DF, Morris TW.

    Antibiotic Resistance Among Ocular Pathogens in the United States: Five-Year Results From the Antibiotic Resistance Monitoring in Ocular Microorganisms (ARMOR) Surveillance Study. JAMA Ophthalmol. 2015 Dec;133(12):1445-54.

    12. Asbell PA, Sahm DF, Shaw M, Draghi DC, Brown NP. Increasing prevalence of methicillin resistance in serious ocular infections caused by Staphylococcus aureus in the United States: 2000 to 2005. J Cataract Refract Surg. 2008 May;34(5):814-8.

    13. Shanmuganathan VA, Armstrong M, Buller A, Tullo AB. External ocular infections due to methicillin-resistant Staphylococcus aureus (MRSA). Eye (Lond). 2005 Mar;19(3):284-91.

    14. Lee C-R, Cho IH, Jeong BC, Lee SH. Strategies to Minimize Antibiotic Resistance. Int J Environ Res Public Health. 2013 Sep; 10(9):4274-4305.

    15. Brown V. Bacteria R Us. Pacific Standard. Available at: https://psmag.com/bacteria-r-us-61e66d1b6792#.bvsgaaf75. Accessed 8/27/16.

    Katherine M. Mastrota, MS, OD, FAAO, Dipl ABO
    Director of Optometry, New York Hotel Trades Council, Hotel Association of New York City, Health Center, Inc.

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