Skip to main content

Advertisement

SpringerLink
Log in

Moraxella species: infectious microbes identified by use of time-of-flight mass spectrometry

  • Clinical Investigation
  • Published:
Japanese Journal of Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

To report the clinical manifestations, identification, antimicrobial susceptibilities, and treatment outcomes of ocular infections caused by Moraxella species.

Study design

Retrospective study.

Patients and methods

The medical records of all patients treated at the Departments of Ophthalmology of the Ogaki Municipal Hospital and the Gifu University Graduate School of Medicine for ocular infections caused by Moraxella species between January 2011 and June 2017 were examined. The stored Moraxella species isolated from ocular samples were identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS), molecular identification, and the biochemical properties.

Results

Sixteen eyes of 16 patients were treated for Moraxella ocular infections. The patients’ median age was 72 years. A predisposing systemic or ocular condition was identified in 15 of the patients. Nine of the patients developed keratitis; four, conjunctivitis; and three, blebitis. M lacunata (6 eyes), M catarrhalis (6), M nonliquefaciens (3), and M osloensis (1) were identified by MALDI-TOF MS. All isolates were sensitive to levofloxacin, tobramycin, ceftazidime, ceftriaxone, and cefazolin. Twelve patients with keratitis or blebitis were treated with various topical antimicrobial combinations, and systemic antibiotics were used in 10 of the 12 patients. The mean time for the complete closure of the epithelial defects with keratitis was 24 days. The visual outcomes after treatment were favorable except in 1 keratitis patient who underwent enucleation.

Conclusions

The use of duo-therapy with a combination of fluoroquinolone and cefmenoxime should be considered in cases nonresponsive to monotherapy, such as keratitis and bleb-associated infections. MALDI-TOF MS is useful for the identification of Moraxella to the species level.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Berrocal AM, Scott IU, Miller D, Flynn HW Jr. Endophthalmitis caused by Moraxella species. Am J Ophthalmol. 2001;132:788–90.

    Article  CAS  PubMed  Google Scholar 

  2. Schaefer F, Bruttin O, Zografos L, Guex-Crosier Y. Bacterial keratitis: a prospective clinical and microbiological study. Br J Ophthalmol. 2001;85:842–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Berrocal AM, Scott IU, Miller D, Flynn HW Jr. Endophthalmitis caused by Moraxella osloensis. Graefes Arch Clin Exp Ophthalmol. 2002;240:329–30.

    Article  PubMed  Google Scholar 

  4. Das S, Constantinou M, Daniell M, Taylor HR. Moraxella keratitis: predisposing factors and clinical review of 95 cases. Br J Ophthalmol. 2006;90:1236–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Inoue H, Suzuki T, Inoue T, Hattori T, Nejima R, Todokoro D, et al. Clinical characteristics and bacteriological profile of Moraxella keratitis. Cornea. 2015;34:110–9.

    Article  Google Scholar 

  6. Tobimatsu Y, Inada N, Shoji J, Yamagami S. Clinical characteristics of 17 patients with Moraxella keratitis. Semin Ophthalmol. 2018;33:726–32.

    Article  PubMed  Google Scholar 

  7. Leung AK, Hon KL, Wong AHC, Wong AS. Bacterial conjunctivitis in childhood: etiology, clinical manifestations, diagnosis, and management. Recent Pat Inflamm Allergy Drug Discov. 2018. https://doi.org/10.2174/1872213x12666180129165718.

    Article  PubMed  Google Scholar 

  8. Varaprasathan G, Miller K, Lietman T, Whitcher JP, Cevallos V, Okumoto M, et al. Trends in the etiology of infectious corneal ulcers at the F. I. Proctor Foundation. Cornea. 2004;23:360–4.

    Article  PubMed  Google Scholar 

  9. Cornut PL, Chiquet C, Bron A, Romanet JP, Lina G, Lafontaine PO, FRIENDS Group, et al. Microbiologic identification of bleb-related delayed-onset endophthalmitis caused by Moraxella species. J Glaucoma. 2008;7:541–5.

    Article  Google Scholar 

  10. Jacobs DJ, Leng T, Flynn HW Jr, Shi W, Miller D, Gedde SJ. Delayed-onset bleb-associated endophthalmitis: presentation and outcome by culture result. Clin Ophthalmol. 2011;5:739–44.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Takahashi H, Fujimura S, Ubukata S, Sato E, Shoji M, Utagawa M, et al. Pneumonia after earthquake, Japan, 2011. Emerg Infect Dis. 2012;18:1909–11.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Dingle TC, Butler-Wu SM. Maldi-tof mass spectrometry for microorganism identification. Clin Lab Med. 2013;33:589–609.

    Article  PubMed  Google Scholar 

  13. Jabs DA. Improving the reporting of clinical case series. Am J Ophthalmol. 2005;139:900–5.

    Article  PubMed  Google Scholar 

  14. Masaki T, Ohkusu K, Ezaki T, Miyamoto H. Nocardia elegans infection involving purulent arthritis in humans. J Infect Chemother. 2012;18:386–9.

    Article  PubMed  Google Scholar 

  15. Pettersson B, Kodjo A, Ronaghi M, Uhlén M, Tønjum T. Phylogeny of the family Moraxellaceae by 16S rDNA sequence analysis, with special emphasis on differentiation of Moraxella species. Int J Syst Bacteriol. 1998;48:75–89.

    Article  CAS  PubMed  Google Scholar 

  16. Orlans HO, Hornby SJ, Bowler IC. In vitro antibiotic susceptibility patterns of bacterial keratitis isolates in Oxford, UK: a 10-year review. Eye (Lond). 2011;25:489–93.

    Article  CAS  Google Scholar 

  17. National Surveillance of Infectious Keratitis in Japan. National Surveillance of Infectious Keratitis in Japan: current status of isolates, patient background, and treatment. Nippon Ganka Gakkai Zasshi. 2006;110:961–72 (in Japanese).

    Google Scholar 

  18. Tan SZ, Walkden A, Au L, Fullwood C, Hamilton A, Qamruddin A, et al. Twelve-year analysis of microbial keratitis trends at a UK tertiary hospital. Eye (Lond). 2017;31:1229–36.

    Article  CAS  Google Scholar 

  19. Mian SI, Malta JB. Moraxella keratitis: risk factors, presentation, and management. Acta Ophthalmol. 2011;89:e208–9.

    Article  PubMed  Google Scholar 

  20. Barash A, Chou TY. Moraxella atlantae keratitis presenting with an infectious ring ulcer. Am J Ophthalmol Case Rep. 2017;7:62–5.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Morax V. Note sur un diplobacille pathogène pour la conjonctivite humaine. Ann Inst Pasteur. 1896;10:337–45.

    Google Scholar 

  22. Axenfeld T. Über die chronische Diplobacille conjunctivitis. Zentralbl Bakteriol. 1897;21:1–9.

    Google Scholar 

  23. Cobo LM, Coster DJ, Peacock J. Moraxella keratitis in a nonalcoholic population. Br J Ophthalmol. 1981;65:683–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Shah SS, Ruth A, Coffin SE. Infection due to Moraxella osloensis: case report and review of the literature. Clin Infect Dis. 2000;30:179–81.

    Article  CAS  PubMed  Google Scholar 

  25. Dalmon C, Porco TC, Lietman TM, Prajna NV, Prajna L, Das MR, et al. The clinical differentiation of bacterial and fungal keratitis: a photographic survey. Invest Ophthalmol Vis Sci. 2012;53:1787–91.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Garg P, Mathur U, Athmanathan S, Rao GN. Treatment outcome of Moraxella keratitis: our experience with 18 cases: a retrospective review. Cornea. 1999;18:176–81.

    Article  CAS  PubMed  Google Scholar 

  27. Suzuki T, Ohashi Y. Combination effect of antibiotics against bacteria isolated from keratitis using fractional inhibitory concentration index. Cornea. 2013;32:e156–60.

    Article  PubMed  Google Scholar 

  28. Laukeland H, Bergh K, Bevanger L. Posttrabeculectomy endophthalmitis caused by Moraxella nonliquefaciens. J Clin Microbiol. 2002;40:2668–770.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Song A, Scott IU, Flynn HW Jr, Budenz DL. Delayed-onset bleb-associated endophthalmitis: clinical features and visual acuity outcomes. Ophthalmology. 2002;109:985–91.

    Article  PubMed  Google Scholar 

  30. Busbee BG, Recchia FM, Kaiser R, Nagra P, Rosenblatt B, Pearlman RB. Bleb-associated endophthalmitis: clinical characteristics and visual outcomes. Ophthalmology. 2004;111:1495–503.

    Article  PubMed  Google Scholar 

  31. Yamamoto T. Bleb-related infection: clinical features and management. Taiwan J Ophthalmol. 2012;2:2–5.

    Article  Google Scholar 

  32. Hori N, Mochizuki K, Ishida K, Yamamoto T, Mikamo H. Clinical characteristics and risk factors of glaucoma filtering bleb infections. Nippon Ganka Gakkai Zasshi. 2009;113:951–63 (in Japanese).

    PubMed  Google Scholar 

  33. Nihonyanagi S, Wada T, Adachi Y, Fujimura H, Munekata S, Kanoh Y, et al. Trends in the occurrence and antibiotic susceptibility of Moraxella catarrhalis from 2009 to 2014. Jpn J Med Technol. 2016;65:268–74.

    Google Scholar 

  34. Stull TL, Stanford EJ. Pseudogonococcal ophthalmia neonatorum caused by Branhamella catarrhalis. Pediatr Infect Dis. 1986;5:104–5.

    Article  CAS  PubMed  Google Scholar 

  35. Maruyama Y, Shigemura T, Aoyama K, Nagano N, Nakazawa Y. Bacteremia due to Moraxella osloensis: a case report and literature review. Braz J Infect Dis. 2018;22:60–2.

    Article  PubMed  Google Scholar 

  36. Hansen W, Butzler JP, Fuglesang JE, Henriksen SD. Isolation of penicillin and streptomycin resistant strains of Moraxella osloensis. Acta Pathol Microbiol Scand B Microbiol Immunol. 1974;82:318–22.

    CAS  PubMed  Google Scholar 

Download references

Acknowledgments

We would like to express our gratitude to Mr Haruki Sawamura, PhD, for scientific advice.

Author information

Authors and Affiliations

  1. Department of Ophthalmology, Gifu University Graduate School of Medicine, Gifu, Japan

    Shunsuke Takahashi, Kazuhiro Murata, Kenji Ozawa & Kiyofumi Mochizuki

  2. Department of Ophthalmology, Ogaki Municipal Hospital, Gifu, Japan

    Hiroki Yamada

  3. Department of Ophthalmology, Gifu Municipal Hospital, 7-1 Kashima-cho, Gifu-shi, Gifu, 500-8513, Japan

    Hideaki Kawakami

  4. Department of Clinical Laboratory, Gifu University Graduate School of Medicine, Gifu, Japan

    Asami Nakayama

  5. Department of Clinical Laboratory, Ogaki Municipal Hospital, Gifu, Japan

    Yuko Asano

  6. Department of Clinical Infectious Diseases, Aichi Medical University, Aichi, Japan

    Hiroshige Mikamo

Authors
  1. Shunsuke Takahashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kazuhiro Murata
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kenji Ozawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hiroki Yamada
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Hideaki Kawakami
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Asami Nakayama
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Yuko Asano
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Kiyofumi Mochizuki
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Hiroshige Mikamo
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hideaki Kawakami.

Ethics declarations

Conflicts of interest

S. Takahashi, None; K. Murata, None; K. Ozawa, None; H. Yamada, None; H. Kawakami, None; A. Nakayama, None; Y. Asano, None; K. Mochizuki, None; H. Mikamo, None.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Corresponding author: Hideaki Kawakami

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Takahashi, S., Murata, K., Ozawa, K. et al. Moraxella species: infectious microbes identified by use of time-of-flight mass spectrometry. Jpn J Ophthalmol 63, 328–336 (2019). https://doi.org/10.1007/s10384-019-00669-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10384-019-00669-4

Keywords

Search

Navigation