J Korean Ophthalmol Soc.  2015 Apr;56(4):607-613. 10.3341/jkos.2015.56.4.607.

Clinical Features of Acinetobacter Baumannii Keratitis

Affiliations
  • 1Department of Ophthalmology, Dankook University Hospital, Dankook University College of Medicine, Cheonan, Korea. perfectcure@daum.net

Abstract

PURPOSE
Acinetobacter species are common aerobic gram-negative bacterium that contain polymorphisms. Acinetobacter baumannii keratitis has recently received attention, and has various clinical features. Therefore, it is crucial to determine the appropriate medical treatment for Acinetobacter baumannii keratitis.
CASE SUMMARY
There were two infectious crystalline keratitis patients, two other patients that were co-infected with fungus, and the last patient who had the peripheral corneal ulcer type of keratitis.
CONCLUSIONS
Acinetobacter baumannii keratitis demonstrates multiple clinical features. It forms a biofilm that can bring possible resistance to therapy, and it can also co-infect with fungus. In contrast to general bacterial keratitis which occurs in the form of a central corneal ulcer, we found Acinetobacter baumannii to take on the form of a peripheral corneal ulcer in our experiments on the five keratitis patients. Although Acinetobacter species were originally found to be multidrug-resistant, such resistance was not found in our experiments. However, due to the various problems associated with Acinetobacter baumannii, it is always critical for medical staff to take infection of Acinetobacter baumannii into consideration in keratitis patients.

Keyword

Acinetobacter baumannii; Keratitis

MeSH Terms

Acinetobacter
Acinetobacter baumannii*
Biofilms
Corneal Ulcer
Crystallins
Fungi
Humans
Keratitis*
Medical Staff
Crystallins

Figure

  • Figure 1. (A) Slit-lamp photograph shows the presence of crystal-like white stromal infiltrations with epithelial defect at the center. (B) Six month after treatment.

  • Figure 2. (A) Corneal infiltration in the anterior stroma with conjunctival injection. (B) Two month after treatment.

  • Figure 3. Anterior segment optical coherence tomography (AS-OCT) shows relatively well demarcated horizontal infiltration in the anterior stroma (A: patient 1; B: patient 2).

  • Figure 4. (A) Corneal ulcer with descemetocele at the nasal area, infiltrations at superior limbus. (B) Two days after therapeutic partial keratoplasty, there is immune ring-like infiltration (white arrows). (C) Stromal necrosis at center of cornea (yellow arrows). (D) After therapeutic keratoplasty.

  • Figure 5. (A) Corneal infiltration with feathery margin, epithelial defect at the center of infiltration and conjunctival injection. (B) Two month after treatment.

  • Figure 6. (A) Peripheral corneal ulcer with stromal infiltration. (B) One month after treatment.


Cited by  1 articles

Polymicrobial Keratitis of Pseudomonas aeruginosa, Acinetobacter baumannii, and Ochrobactrum anthropi
Jung Youb Kang, Ju Hwan Song, Ki Yup Nam, Seung Uk Lee, Sang Joon Lee
J Korean Ophthalmol Soc. 2019;60(5):474-479.    doi: 10.3341/jkos.2019.60.5.474.


Reference

References

1. Eveillard M, Kempf M, Belmonte O, et al. Reservoirs of Acinetobacter baumannii outside the hospital and potential involvement in emerging human community-acquired infections. Int J Infect Dis. 2013; 17:e802–5.
Article
2. Marcovich A, Levartovsky S. Acinetobacter exposure keratitis. Br J Ophthalmol. 1994; 78:489–90.
Article
3. Zabel RW, Winegarden T, Holland EJ, Doughman DJ. Acinetobacter corneal ulcer after penetrating keratoplasty. Am J Ophthalmol. 1989; 107:677–8.
Article
4. Crawford PM Jr, Conway MD, Peyman GA. Trauma-induced Acinetobacter lwoffi endophthalmitis with multi-organism recurrence: strategies with intravitreal treatment. Eye (Lond). 1997; 11(Pt 6):863–4.
Article
5. Melki TS, Sramek SJ. Trauma-induced Acinetobacter lwoffi endophthalmitis. Am J Ophthalmol. 1992; 113:598–9.
6. Gopal L, Ramaswamy AA, Madhavan HN, et al. Postoperative endophthalmitis caused by sequestered Acinetobacter calcoaceticus. Am J Ophthalmol. 2000; 129:388–90.
Article
7. Prashanth K, Ranga MP, Rao VA, Kanungo R. Corneal perforation due to Acinetobacter junii: a case report. Diagn Microbiol Infect Dis. 2000; 37:215–7.
Article
8. Khater TT, Jones DB, Wilhelmus KR. Infectious crystalline keratopathy caused by gram-negative bacteria. Am J Ophthalmol. 1997; 124:19–23.
Article
9. Corrigan KM, Harmis NY, Willcox MD. Association of acinetobacter species with contact lens-induced adverse responses. Cornea. 2001; 20:463–6.
Article
10. Kim ST, Lee YC, Heo J, Koh JW. A case of acinetobacter baumannii keratitis after contact lens wearing. J Korean Ophthalmol Soc. 2008; 49:1696–700.
Article
11. Choi JK, Kim IH, Seo JW. A case of keratitis caused by combined infection of multidrug-resistant acinetobacter baumannii and candida parapsilosis. J Korean Ophthalmol Soc. 2012; 53:1167–71.
12. Ruiz J, Núñez ML, Pérez J, et al. Evolution of resistance among clinical isolates of Acinetobacter over a 6-year period. Eur J Clin Microbiol Infect Dis. 1999; 18:292–5.
13. Peleg AY, Seifert H, Paterson DL. Acinetobacter baumannii: emergence of a successful pathogen. Clin Microbiol Rev. 2008; 21:538–82.
14. Zarrilli R, Giannouli M, Tomasone F, et al. Carbapenem resistance in Acinetobacter baumannii: the molecular epidemic features of an emerging problem in health care facilities. J Infect Dev Ctries. 2009; 3:335–41.
Article
15. Gorovoy MS, Stern GA, Hood CI, Allen C. Intrastromal non-inflammatory bacterial colonization of a corneal graft. Arch Ophthalmol. 1983; 101:1749–52.
Article
16. Meisler DM, Langston RH, Naab TJ, et al. Infectious crystalline keratopathy. Am J Ophthalmol. 1984; 97:337–43.
Article
17. Zabel RW, Mintsioulis G, MacDonald I, Tuft S. Infectious crystalline keratopathy. Can J Ophthalmol. 1988; 23:311–4.
18. Kintner JC, Grossniklaus HE, Lass JH, Jacobs G. Infectious crystalline keratopathy associated with topical anesthetic abuse. Cornea. 1990; 9:77–80.
Article
19. Matsumoto A, Sano Y, Nishida K, et al. A case of infectious crystalline keratopathy occurring long after penetrating keratoplasty. Cornea. 1998; 17:119–22.
Article
20. Ormerod LD, Ruoff KL, Meisler DM, et al. Infectious crystalline keratopathy. Role of nutritionally variant streptococci and other bacterial factors. Ophthalmology. 1991; 98:159–69.
21. Elder MJ, Stapleton F, Evans E, Dart JK. Biofilm-related infections in ophthalmology. Eye (Lond). 1995; 9(Pt 1):102–9.
Article
22. Hunts JH, Matoba AY, Osato MS, Font RL. Infectious crystalline keratopathy. The role of bacterial exopolysaccharide. Arch Ophthalmol. 1993; 111:528–30.
23. Costerton JW, Cheng KJ, Geesey GG, et al. Bacterial biofilms in nature and disease. Annu Rev Microbiol. 1987; 41:435–64.
Article
24. Gordon NC, Wareham DW. Multidrug-resistant Acinetobacter baumannii: mechanisms of virulence and resistance. Int J Antimicrob Agents. 2010; 35:219–26.
Article
25. Lee HW, Koh YM, Kim J, et al. Capacity of multidrug-resistant clinical isolates of Acinetobacter baumannii to form biofilm and adhere to epithelial cell surfaces. Clin Microbiol Infect. 2008; 14:49–54.
Article
26. Cevahir N, Demir M, Kaleli I, et al. Evaluation of biofilm pro-duction, gelatinase activity, and mannose-resistant hemagglutination in Acinetobacter baumannii strains. J Microbiol Immunol Infect. 2008; 41:513–8.
27. Vidal R, Dominguez M, Urrutia H, et al. Biofilm formation by Acinetobacter baumannii. Microbios. 1996; 86:49–58.
28. Sridhar MS, Sharma S, Garg P, Rao GN. Epithelial infectious crystalline keratopathy. Am J Ophthalmol. 2001; 131:255–7.
Article
29. Sánchez Ferreiro AV, López Criado A, Muñoz Bellido L. [Crystalline keratopathy in pterigium treatment: case report]. Arch Soc Esp Oftalmol. 2012; 87:179–81.
Article
Full Text Links
  • JKOS
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr