The Challenge of Antibiotic Resistance in Corneal Infection

The discovery and development of antibiotics for treatment of bacterial infections was one of the greatest medical advances of the last century, and it has saved millions of lives. However, as early as 1945, Sir Alexander Fleming expressed concern about the consequences of antibiotic overuse. Seven decades later, antimicrobial resistance (AMR) has reached alarming levels and is now a major public health threat in the twenty-first century. The emergence of multidrug-resistant bacteria such as methicillin-resistant Staphylococcus aureus (MRSA), antibiotic-resistant Streptococcus pneumoniae, vancomycin-resistant Enterococcus, multidrugresistant Pseudomonas aeruginosa, and carbapenem-resistant Enterobacteriaceae among others is raising the specter of a post-antibiotic era. AMR organisms, which initially were largely confined to hospitals, have now found their ways into communities, posing a serious threat to otherwise healthy individuals. MRSA, for instance, caused an estimated 80,461 invasive infections and 11,285 deaths in the US in 2011, and are now common causes of ocular infection. Most derive from specific MRSA lineages that have disseminated throughout the US and other locations, and are associated with particularly serious ocular and orbital infections.