Competing/Conflicts of interest: No stated conflict of interest.
Ocular infections caused by non-tuberculous mycobacteria: update on epidemiology and management
Version of Record online: 4 NOV 2011
© 2011 The Authors. Clinical and Experimental Ophthalmology © 2011 Royal Australian and New Zealand College of Ophthalmologists
Clinical & Experimental Ophthalmology
Volume 40, Issue 5, pages 467–475, July 2012
How to Cite
Girgis, D. O., Karp, C. L. and Miller, D. (2012), Ocular infections caused by non-tuberculous mycobacteria: update on epidemiology and management. Clinical & Experimental Ophthalmology, 40: 467–475. doi: 10.1111/j.1442-9071.2011.02679.x
Funding sources: NIH core grant: P30-EY14801, Research to Prevent Blindness.
- Issue online: 25 JUL 2012
- Version of Record online: 4 NOV 2011
- Accepted manuscript online: 8 SEP 2011 12:16PM EST
- Received 18 February 2011; accepted 30 July 2011.
- bacterial disease;
Background: To provide an update on the frequency, distribution, risk factors and in vitro susceptibility of ocular infections caused by non-tuberculous mycobacteria.
Design: Retrospective study of university clinic patients.
Participants: One hundred thirty-nine patients with culture confirmed non-tuberculous mycobacteria infections seen at Bascom Palmer Eye Institute from January 1980 to July 2007.
Methods: Chart review of data collected included patients' demographics, risk factors, microbiological profiles and clinical outcomes.
Main Outcome Measures: Frequency, distribution, risk factors and in vitro susceptibility of ocular infections caused by non-tuberculous mycobacteria.
Results: A total of 183 non-tuberculous mycobacteria isolates from 142 eyes were identified, with a fourfold increase in the number of eyes infected with non-tuberculous mycobacteria from 1980–1989 (13.4%) to 2000–2007 (56.3%). Eighty-three percent of non-tuberculous mycobacteria isolates were identified as M. abscessus/chelonae. The majority (91%) of isolates were recovered within 10 days. Common diagnoses included keratitis (36.6%), scleral buckle infections (14.8%) and socket/implant infections (14.8%). Identifiable risk factors were presence of biomaterials (63.1%), ocular surgery (24.1%) and steroid exposure (77%). The median time from diagnosis of culture positive non-tuberculous mycobacteria infection to resolution was 13 to 24 weeks. Combination therapy was used to treat 80% of infected eyes. In vitro susceptibility of non-tuberculous mycobacteria isolates were: amikacin, 81%; clarithromycin, 93%; and moxifloxacin, 21%.
Conclusions: The incidence of ocular infections caused by non-tuberculous mycobacteria has increased within the last 8 years, with a high number of biomaterial associated infections among this group. Clinical diagnosis and microbiological confirmation of non-tuberculous mycobacteria infections remains challenging. Patient outcomes may be improved by early diagnosis, appropriate therapy and removal of biomaterials.