Bausch + Lomb Announces Update From Antibiotic Resistance Monitoring in Ocular Microorganism (ARMOR) Study
Bausch + Lomb announced the results from nearly 10 years of the ARMOR (Antibiotic Resistance Monitoring in Ocular Microorganisms) surveillance study, presented at the ARVO meeting in Vancouver. Researchers also presented preliminary 2018 surveillance data on antibiotic resistance levels. Initiated in 2009, ARMOR is the only ongoing multicenter survey of antibiotic resistance patterns specific to ocular pathogens in the United States.
The ARMOR study tracks in vitro antibiotic susceptibility profiles among ocular bacterial pathogens of significance. Clinically relevant isolates of Staphylococcus aureus, coagulase-negative staphylococci (CoNS), Streptococcus pneumoniae, Pseudomonas aeruginosa, and Haemophilus influenzae from ocular infections are collected and subjected to antibiotic susceptibility testing.
In the longitudinal trend analysis presentation, ARMOR researchers reported resistance trends in staphylococcal infections, which included 2108 Staphylococcus aureus and 1721 coagulase-negative staphylococci that were collected since January 2009. The results of the analysis confirmed the previously reported decrease in methicillin resistance (MR) among S. aureus (P<0.001; 40 percent in 2018), but not among CoNS (P=0.762), with approximately half of CoNS exhibiting MR each year. In addition, decreased resistance was observed among S. aureus to azithromycin (62 percent to 60 percent), ciprofloxacin (39 percent to 30 percent), tobramycin (24 percent to 9 percent), and chloramphenicol (6.6 percent to 4.4 percent; P≤0.006 for all). Among CoNS, resistance to ciprofloxacin decreased (46 percent to 31 percent; P<0.001), while there was increased resistance to tobramycin (19 percent to 23 percent; P=0.036). As in previous years, a high proportion of methicillin-resistant staphylococci demonstrated multidrug resistance (≥3 antibiotic classes).
In the 2018 preliminary update, ARMOR researchers reported a total of 414 isolates collected from 15 participating sites in the United States. Among staphylococci, resistance rates appeared similar to 2017 rates, with considerable resistance among staphylococci to azithromycin (52-60 percent), oxacillin/methicillin (30-49 percent), and ciprofloxacin (30-31 percent). CoNS isolates also exhibited resistance to trimethoprim (25 percent) and tobramycin (23 percent). Multidrug resistance (MDR) was observed in 30 percent of S. aureus and 40 percent of CoNS and was especially prevalent among methicillin-resistant staphylococci (72-77 percent). Isolates of S. pneumoniae were resistant to azithromycin (33 percent) and oral penicillin (28 percent) with no resistance to fluoroquinolones. All isolates of P. aeruginosa were susceptible to fluoroquinolones, with six percent exhibiting resistance to polymyxin B. With the exception of a single tetracycline-resistant isolate, all H. influenzae were susceptible to tested drugs.2
“As the only annual nationwide surveillance study of its kind, these data continue to serve as an invaluable resource to eye care professionals in tracking updated susceptibility rates to commonly used antibiotics among ocular pathogens,” Penny A. Asbell, MD, lead ARMOR study author, professor and chair, the University of Tennessee Health Science Center, and director, Hamilton Eye Institute, Memphis, Tennessee, said in a company news release. “As an eye care professional myself, I’m grateful for the opportunity to equip practitioners with resources to help them make knowledgeable decisions in meeting the needs of their patients.”
“The ARMOR study is critically important research for the eye health community – providing a platform to identify key trends and provide insights among common ocular pathogens,” Yolande Barnard, vice president and general manager, U.S. Pharmaceuticals, Bausch + Lomb, said in the news release. “Bausch + Lomb is proud to continue its support of this unique ongoing study to inform eye care practitioners so that they can help manage the treatment of their patients with ocular bacterial conjunctivitis.”
References
- Asbell, Penny A,.; Sanfilippo, Christine M; DeCory, Heleen H. “Longitudinal Trends in Antibiotic Resistance Among Staphylococci Collected in the ARMOR Study.” [The Association for Research in Vision and Ophthalmology (ARVO) Annual Meeting in Vancouver, BC, on Sunday, April 28, 1:00-2:45, Abstract Number: B0331].
- Sanfilippo, Christine M.; DeCory, Heleen H.; Asbell, Penny A. “Antibiotic Resistance Among Ocular Pathogens – An Update from the 2018 ARMOR Study.” [The Association for Research in Vision and Ophthalmology (ARVO) Annual Meeting in Vancouver, BC, on Sunday, April 28, 8:00-9:45, Abstract Number: B0365].