Coline Legendre1, Hélène Hannetel1, Anne-Gaëlle Ranc1,2,3, Widad Bezza4, Laurence Pages5, François Vandenesch1,6,7, Anne Tristan1,6,7, Anne Doleans-Jordheim8,9,10. 1. Laboratory of Microbiology, Groupement Hospitalier Est, Hospices Civils de Lyon, Bron, France. 2. French Reference Center for Legionella, Laboratory of Microbiology, Groupement Hospitalier Est, Hospices Civils de Lyon, Bron, France. 3. CIRI, International Center of Infectious Research, INSERM U1111, CNRS UMR5308, University of Lyon 1, ENS de Lyon, Lyon, France. 4. Ophthalmology Department, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France. 5. Research Group on «Bacterial Opportunistic Pathogens and Environment», UMR 5557 Ecologie Microbienne, CNRS, University of Lyon 1, ENVL, Lyon, France. 6. French Reference Center for Staphylococci, Laboratory of Microbiology, Groupement Hospitalier Est, Hospices Civils de Lyon, Bron, France. 7. CIRI, International Center for Infectiology Research, INSERM U851, University of Lyon 1, Lyon, France. 8. Laboratory of Microbiology, Groupement Hospitalier Est, Hospices Civils de Lyon, Bron, France. anne.doleans-jordheim@univ-lyon1.fr. 9. Research Group on «Bacterial Opportunistic Pathogens and Environment», UMR 5557 Ecologie Microbienne, CNRS, University of Lyon 1, ENVL, Lyon, France. anne.doleans-jordheim@univ-lyon1.fr. 10. Groupe de Recherche "Bactéries pathogènes opportunistes et environnement", UMR 5557 Ecologie Microbienne, Laboratoire de Mycologie-Microbiologie (Pavillon Nétien 3ème étage), Faculté de Pharmacie-ISPB, Université Claude Bernard Lyon 1, 8, Avenue Rockefeller, 69373, Lyon Cedex 08, France. anne.doleans-jordheim@univ-lyon1.fr.
Abstract
PURPOSE: To report a farmer's corneal abscess caused by an unusual pathogen: Listeria monocytogenes fluoroquinolone resistant. METHODS: A 78-year-old farmer presented a central corneal abscess associated with 1-mm hypopyon and decreased visual acuity evolving since 2 weeks. First an antibiotic therapy associating oral ofloxacin and topical ciprofloxacin, vancomycin and ceftazidime was started. Different samples of the abscess were performed and sent to different microbiological laboratories. RESULT: Listeria monocytogenes was isolated after 2 days of culture. Antibiotics sensitivity showed resistance to ciprofloxacin, fosfomycin and fusidic acid. Ceftazidime was changed for gentamicin, and after 1 month of treatment the abscess decreased considerably. CONCLUSION: This case demonstrated that even if Listeria is rarely involved in ocular abscess, it must be evocated for people with risk factors as farmers. This suspicion should lead to an extended incubation to identify the pathogen. The analysis of Listeria resistance is essential to start an efficient therapy.
PURPOSE: To report a farmer's corneal abscess caused by an unusual pathogen: Listeria monocytogenesfluoroquinolone resistant. METHODS: A 78-year-old farmer presented a central corneal abscess associated with 1-mm hypopyon and decreased visual acuity evolving since 2 weeks. First an antibiotic therapy associating oral ofloxacin and topical ciprofloxacin, vancomycin and ceftazidime was started. Different samples of the abscess were performed and sent to different microbiological laboratories. RESULT: Listeria monocytogenes was isolated after 2 days of culture. Antibiotics sensitivity showed resistance to ciprofloxacin, fosfomycin and fusidic acid. Ceftazidime was changed for gentamicin, and after 1 month of treatment the abscess decreased considerably. CONCLUSION: This case demonstrated that even if Listeria is rarely involved in ocular abscess, it must be evocated for people with risk factors as farmers. This suspicion should lead to an extended incubation to identify the pathogen. The analysis of Listeria resistance is essential to start an efficient therapy.