Purpose To study the incidence, clinical features and outcomes of multidrug-resistant (MDR) bacterial keratitis. Methods All cases of MDR-bacterial keratitis presenting to our institute over a period of 2 years were retrospectively analysed. Details of risk factors, size and depth of infiltrate, treatment, and outcome were noted. Antibiotic susceptibility tests were done on the ocular isolates from the culture of samples obtained from ocular infections, and resistance or sensitivity of the organisms to the commonly used antibiotics was studied. Results Forty patients were diagnosed with MDR-bacterial keratitis in the study period. The mean age of patients was 50.9±25.4 years. Most common risk factors were vegetative trauma (n=12, 30.0%), followed by corneal transplantation (n=7, 17.5%) and systemic comorbidities (n=7, 17.5%). Infiltrate was small (<6 mm) in 22 (55%) and large (>6 mm) in 18 (45%) patients. It involved the superficial, mid and deep stroma in 11 (27.5%), 9 (22.5%) and 15 (37.5%) cases, respectively. Gram-negative bacilli (n=18, 45%) were the maximum, among which Pseudomonas aeruginosa (15%) was the most common. Resistance to 3 (n=17, 42.5%) and 4 (n=17, 42.5%) classes of antibiotics was the most commonly observed. One (2.5%) patient showed resistance to all seven classes of drugs tested. Complete resolution of infection was seen in 15 (37.5%) MDR patients on medical management alone. Five (12.5%) patients underwent therapeutic penetrating keratoplasty. Size of the infiltrate was found to have a significant correlation with the outcome (p=0.002). Conclusion MDR keratitis, despite being a challenge to treat, can be successfully managed by medical therapy alone, if appropriate therapy is started early in the clinical course. All data relevant to the study are included in the article or uploaded as supplementary information.

中文翻译：

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耐多药角膜炎：具有挑战性但易于控制

目的 研究多重耐药 (MDR) 细菌性角膜炎的发病率、临床特征和结果。方法 回顾性分析 2 年内到我院就诊的所有 MDR-细菌性角膜炎病例。记录了风险因素、浸润的大小和深度、治疗和结果的详细信息。对来自眼部感染样本培养物的眼部分离株进行了抗生素敏感性试验，并研究了生物体对常用抗生素的耐药性或敏感性。结果 40 名患者在研究期间被诊断为 MDR-细菌性角膜炎。患者的平均年龄为 50.9±25.4 岁。最常见的危险因素是植物创伤 (n=12, 30.0%)，其次是角膜移植 (n=7, 17.5%) 和全身合并症 (n=7, 17.5%)。22 名 (55%) 患者浸润较小 (<6 mm)，18 名 (45%) 患者浸润较大 (>6 mm)。累及表层间质、中层间质和深部间质分别为 11 例（27.5%）、9 例（22.5%）和 15 例（37.5%）。革兰氏阴性杆菌（n=18，45%）最多，其中铜绿假单胞菌（15%）最常见。最常见的是对 3 类 (n=17, 42.5%) 和 4 (n=17, 42.5%) 类抗生素的耐药性。一名 (2.5%) 患者对所有七类测试药物均表现出耐药性。15 名 (37.5%) 仅接受药物治疗的 MDR 患者感染完全消退。五名 (12.5%) 患者接受了治疗性穿透性角膜移植术。发现浸润的大小与结果有显着相关性 (p=0.002)。结论 MDR 角膜炎尽管是治疗的挑战，如果在临床过程的早期开始适当的治疗，仅通过药物治疗就可以成功控制。所有与研究相关的数据都包含在文章中或作为补充信息上传。