Longitudinal Nationwide Antimicrobial Susceptibility Surveillance in Ocular Isolates:

Results from Ocular TRUST 2

Penny A. Asbell, MD1

Daniel F. Sahm, MD2

1Mount Sinai School of Medicine, New York, NY; 2Eurofins Medinet, Inc, Anti-Infective Services, Herndon, VA

Financial Disclosure: Dr. Asbell has served as a consultant to Inspire Pharmaceuticals and has received lecture fees from Alcon Laboratories, Allergan Pharmaceuticals, Santen Pharmaceutical, Inspire Pharmaceuticals, and Vistakon Pharmaceuticals. Dr. Sahm is a full-time employee of Eurofins Medinet, Inc., Anti-Infective Services and has received lecture fees from Vistakon Pharmaceuticals.

Ocular TRUST: Nationwide Antimicrobial Susceptibility Surveillance Program

Ocular isolates only

Initiated in 2005

Largest surveillance program with centralized in vitro susceptibility testing

Annual surveys providing longitudinal data

Ocular TRUST 2 (2006-2007)

Susceptibility testing specific to ocular isolates

Pathogens Antimicrobials

S. aureus Ciprofloxacin S. epidermidis Gatifloxacin S. pneumoniae Levofloxacin H. influenzae Moxifloxacin

Azithromycin

Penicillin

Polymyxin B

Tobramycin

Trimethoprim

Ocular TRUST: Participating Sites

State with participating

institution

Participating

Eye Centers (10)

8

50

959389

62

17

100 99

Ocular TRUST 2: S. aureus Susceptibility

MSSA (N=71) MRSA (N=84)

20

40

60

80

100

% S

usc

epti

ble

CIPG

ATLE

VM

OX AZI

PENPLY

XTO

BTR

I

18

CIPG

ATLE

VM

OX AZI

PENPLY

XTO

BTR

I

46

23

815

6560

83

58

38

5

9888

Ocular TRUST 2: Coagulase-Negative Staphylococci Susceptibility

Methicillin-susceptible (N=40) Methicillin-resistant (N=52)

20

40

60

80

100

% S

usc

epti

ble

CIPG

ATLE

VM

OX AZI

PENPLY

XTO

BTR

I44

CIPG

ATLE

VM

OX AZI

PENPLY

XTO

BTR

I

Ocular TRUST 2: S. pneumoniae and H. influenzae Susceptibility

S. pneumoniae (N=198) H. influenzae (N=144)

100

8592

100

69 70

2

80

20

40

60

80

100

% S

usc

epti

ble

CIPG

ATLE

VM

OX AZI

PENPLY

XTO

BTR

I

100

CIPG

ATLE

VM

OX AZI

PENPLY

XTO

BTR

I

Ocular TRUST 2: Overview

Methicillin resistance in staphylococci marker for multi-drug resistance

Fluoroquinolones most consistently active agents across ocular pathogens

Fluoroquinolone susceptibility profileGatifloxacin = Levofloxacin = MoxifloxacinModest diminution in S. pneumoniae

susceptibility to ciprofloxacin Polymixin B and penicillin most limited activity