Staphylococcus aureus Keratitis in Taiwan: Genotyping, Antibiotic Susceptibility, and Clinical Features

• Published in: International journal of molecular sciences Vol. 23; no. 19; p. 11703
• Main Authors: Hsiao, Ching-Hsi, Kang, Eugene Yu-Chuan, Yeh, Lung-Kun, Ma, David H. K., Chen, Hung-Chi, Hung, Kuo-Hsuan, Huang, Yhu-Chering
• Format: Journal Article
• Language: English
• Published: Basel MDPI AG 03.10.2022; MDPI
• Subjects: Antibiotics; Cloning; Epidemiology; Genes; Pathogens; Risk factors; Staphylococcus infections; Ulcers; Virulence; United States > US; Taiwan
• ISSN: 1422-0067; 1661-6596; 1422-0067
• DOI: 10.3390/ijms231911703

Staphylococcus aureus is an important pathogen for keratitis, a vision-threatening disease. We aimed to investigate the genotyping, antibiotic susceptibility, and clinical features of S. aureus keratitis, and to explore the possible role of Panton–Valentine leucocidin (PVL), a major virulence factor of S. aureus. We recruited 49 patients with culture-proven S. aureus keratitis between 2013 and 2017 at Chang Gung Memorial Hospital, Taiwan. PVL gene, multilocus sequence type (MLST), staphylococcal cassette chromosome mec (SCCmec), and pulsed-field gel electrophoresis (PFGE) were performed. Antibiotic susceptibility was verified using disk diffusion/E test. There were 49 patients with S. aureus keratitis; 17 (34.7%) were caused by methicillin-resistant S. aureus (MRSA) and 9 (18.4%) isolates had PVL genes. The predominant genotyping of MRSA isolates was CC59/PFGE type D/SCCmec VT/PVL (+). All methicillin-sensitive S. aureus (MSSA) and approximately 60% MRSA were susceptible to fluoroquinolones. No significant differences in clinical features, treatments, and visual outcomes were observed between MRSA/MSSA or PVL(+)/PVL(−) groups. In Taiwan, approximately one third of S. aureus keratitis was caused by MRSA, mainly community-associated MRSA. Although MRSA isolates were more resistant than MSSA, clinical characteristics were similar between two groups. Fluoroquinolones could be good empiric antibiotics for S. aureus keratitis.