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Multiple drug-resistant Alcaligenes xylosoxidans keratitis in a sanitation worker.
Eye Contact Lens. 2009 Jul; 35(4):212-4.EC

Abstract

PURPOSE

To report a case of daily wear soft contact lens-associated keratitis caused by Alcaligenes xylosoxidans in a portable toilet sanitation worker.

METHODS

A previously healthy 30-year-old man presented with bilateral decreased vision, redness, and irritation, beginning 1 week earlier. The patient had been treated with moxifloxocin for 1 week before presentation without improvement. Bacterial staining cultures were performed from corneal scrapings, contact lenses, contact lens case, and solution. Preliminary culture results and antibiotic sensitivities were generated using an automated identification system. Positive results from the contact lens, case, and solution were confirmed using polymerase chain reaction (PCR).

RESULTS

The contact lenses, contact lens case, and solution cultures revealed heavy growth of A. xylosoxidans. These findings were confirmed by PCR. The organism was found to be resistant to aminoglycosides, fluoroquinolones, and cephalosporins. The patient was started on polymyxin B or trimethoprim. After 21 days of treatment, the infection completely resolved with a final spectacle-corrected visual acuity of 20/25.

CONCLUSIONS

To our knowledge, this is the first case report of a corneal infection caused by A. xylosoxidans, which was isolated and identified from a contact lens, case, and solution using culture and PCR technique as well the first description of ocular surface disease resolution after the treatment with topical polymyxin B or trimethoprim. A. xylosoxidans should be considered as uncommon but potential pathogen capable of infectious spread through contaminated contact lens solution.

Authors+Show Affiliations

Department of Ophthalmology and Visual Science, University of Chicago, IL 60637, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19516143

Citation

Kiernan, Daniel F., et al. "Multiple Drug-resistant Alcaligenes Xylosoxidans Keratitis in a Sanitation Worker." Eye & Contact Lens, vol. 35, no. 4, 2009, pp. 212-4.
Kiernan DF, Chin EK, Sclafani LA, et al. Multiple drug-resistant Alcaligenes xylosoxidans keratitis in a sanitation worker. Eye Contact Lens. 2009;35(4):212-4.
Kiernan, D. F., Chin, E. K., Sclafani, L. A., & Saidel, M. A. (2009). Multiple drug-resistant Alcaligenes xylosoxidans keratitis in a sanitation worker. Eye & Contact Lens, 35(4), 212-4. https://doi.org/10.1097/ICL.0b013e3181aac4fd
Kiernan DF, et al. Multiple Drug-resistant Alcaligenes Xylosoxidans Keratitis in a Sanitation Worker. Eye Contact Lens. 2009;35(4):212-4. PubMed PMID: 19516143.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Multiple drug-resistant Alcaligenes xylosoxidans keratitis in a sanitation worker. AU - Kiernan,Daniel F, AU - Chin,Eric K, AU - Sclafani,Louise A, AU - Saidel,Michael A, PY - 2009/6/12/entrez PY - 2009/6/12/pubmed PY - 2009/10/7/medline SP - 212 EP - 4 JF - Eye & contact lens JO - Eye Contact Lens VL - 35 IS - 4 N2 - PURPOSE: To report a case of daily wear soft contact lens-associated keratitis caused by Alcaligenes xylosoxidans in a portable toilet sanitation worker. METHODS: A previously healthy 30-year-old man presented with bilateral decreased vision, redness, and irritation, beginning 1 week earlier. The patient had been treated with moxifloxocin for 1 week before presentation without improvement. Bacterial staining cultures were performed from corneal scrapings, contact lenses, contact lens case, and solution. Preliminary culture results and antibiotic sensitivities were generated using an automated identification system. Positive results from the contact lens, case, and solution were confirmed using polymerase chain reaction (PCR). RESULTS: The contact lenses, contact lens case, and solution cultures revealed heavy growth of A. xylosoxidans. These findings were confirmed by PCR. The organism was found to be resistant to aminoglycosides, fluoroquinolones, and cephalosporins. The patient was started on polymyxin B or trimethoprim. After 21 days of treatment, the infection completely resolved with a final spectacle-corrected visual acuity of 20/25. CONCLUSIONS: To our knowledge, this is the first case report of a corneal infection caused by A. xylosoxidans, which was isolated and identified from a contact lens, case, and solution using culture and PCR technique as well the first description of ocular surface disease resolution after the treatment with topical polymyxin B or trimethoprim. A. xylosoxidans should be considered as uncommon but potential pathogen capable of infectious spread through contaminated contact lens solution. SN - 1542-233X UR - https://www.unboundmedicine.com/medline/citation/19516143/Multiple_drug_resistant_Alcaligenes_xylosoxidans_keratitis_in_a_sanitation_worker_ L2 - https://doi.org/10.1097/ICL.0b013e3181aac4fd DB - PRIME DP - Unbound Medicine ER -