Shifting Trends in Bacterial Keratitis in Taiwan: A 10-Year Review in a Tertiary-Care Hospital.

To the Editor: We commend Hsiao et al for an excellent study. However, a few points need further clarification. First, the term “middle to deep corneal infiltrates” used by the authors encompasses what depth of the cornea? Second, what could be the reason for the low bacterial culture positivity rate of 49.3%? Third, could the increase in the oxacillin susceptibility rate be attributed to the increase in methicillinresistant Staphylococcus aureus (MRSA)? Fourth, in vitro susceptibility testing was done only for ciprofloxacin. Why was it not done for the fourth-generation fluoroquinolones? Fifth, what could be the reason for the increased ciprofloxacin sensitivity of S. aureus, including MRSA strains in Taiwan, even though several studies have reported a significantly increasing trend of ciprofloxacin resistance (approximately 30%) among corneal pathogens, particularly in S. aureus? Sixth, the authors need to clarify how many patients were treatment naive? Was any washout period given before the scrapings were done?