Extensively drug-resistant Pseudomonas aeruginosa keratitis
case report of successful treatment with topical colistin in a nursing-home resident
DOI:
https://doi.org/10.70313/2718.7446.v18.n4.459Keywords:
pseudomonas aeruginosa, antibiotic resistance, colistin, nursing home, senior adults, risk factorsAbstract
Objective: Pseudomonas aeruginosa keratitis can progress aggressively, sometimes leading to corneal perforation. Topical antibiotic treatment is increasingly challenged by the emergence of resistant strains. Topical colistin 0.19% has recently emerged as a therapeutic alternative. This report presents a case successfully treated with this agent in an elderly nursing-home resident.
Case report: A 72-year-old woman with a history of cerebrovascular accident, diabetes, lagophthalmos, and previous corneal ulcer under prolonged topical gatifloxacin therapy presented with a 5-day history of pain and redness in the left eye. Slit-lamp examination revealed a corneal abscess. Microbiological analysis of the corneal scraping identified Pseudomonas aeruginosa “extensively drug-resistant,” susceptible only to colistin. Treatment with topical colistin 0.19% was initiated, leading to progressive clinical improvement and complete resolution of the infection.
Conclusion: In cases of Pseudomonas aeruginosa showing extensive resistance but sensitivity to colistin, timely topical use of colistin 0.19% may achieve complete recovery. This case underscores the importance of microbiological sampling and antibiotic susceptibility testing to guide appropriate therapy, particularly in institutionalized elderly patients with ocular surface vulnerability.
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