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Disease&Treatment/Cornea&Ocular surfaces
Classification, symptoms, prognosis, and antibiotic resistance of bacterial keratitis caused by Staphylococcus spp.
eye_doc 2025. 4. 21. 23:04
Staphylococcus species are the most common causative bacteria of microbial keratitis in South Korea. This article reviews the classification, clinical manifestations, prognosis, and rising antibiotic resistance among staphylococcal infections.
๐น Key Clinical Insights
- Classification
- Coagulase-positive: Staphylococcus aureus
- Coagulase-negative: Staphylococcus epidermidis, others
- S. aureus Keratitis
- Risk factors: dry eye, HSV keratitis, bullous keratopathy, atopy
- Findings: defined stromal infiltration, satellite lesions, hypopyon, possible perforation
- S. epidermidis Keratitis
- Mild presentation, good prognosis, >50% reach VA ≥ 0.5
- Often occurs in spring or post-traumatic rural settings
- Methicillin Resistance (MRS)
- MRSA, MRSE increasingly common in both hospitals and communities
- Despite resistance, 4th-generation fluoroquinolones remain effective in most cases
- Community-acquired MRSA rose from 46.7% (2002) to 88.5% (2008)
๐ Staphylococcal Keratitis Summary Table (English)
ClassificationKey SpeciesClinical FeaturesPrognosis / Notes
| Coagulase-positive Staph. | Staph. aureus | Stromal infiltrate, satellite lesions, possible hypopyon | Aggressive course, needs early management |
| Coagulase-negative Staph. | Staph. epidermidis | Mild disease, rare perforation, good visual recovery | Post-trauma keratitis common in rural areas |
| Methicillin-resistant Staph. | MRSA, MRSE | Resistant to methicillin-class antibiotics | Community spread increasing; fluoroquinolones still effective |