Bacterial and Fungal Keratitis: A Retrospective Analysis at a University Hospital in Switzerland

Abstract

Background Infectious keratitis is a serious corneal disease and may lead to permanent visual deterioration if not treated rapidly and effectively. In order to determine possible changes in the spectrum of pathogens over time, we evaluated the pathogenic organisms of keratitis at a university hospital in Switzerland, comparing two time periods within a decade. Methods In this retrospective study, 417 patients with the clinical diagnosis of bacterial or fungal keratitis in 2006/07 and 2015/16 were enrolled. In an additional analysis, all cases of fungal keratitis between 2006 and 2016 were evaluated. Collected parameters were age, gender, side, use of contact lenses, systemic, neurological and ocular diseases, trauma, previous surgery, and systemic and topical therapy before presentation. In each patient, microbiological results of corneal smears such as growth and antibiotic resistance were analysed. Results A total of 163 and 254 eyes were included in 2006/07 and 2015/16, respectively. In 2006/07, a culture of smears revealed a bacterial cause in 70 eyes (42.9%) and a fungal cause in 4 eyes (2.5%), whereas in 2015/16, bacterial growth was found in 115 eyes (45.3%) and fungal growth in 6 eyes (2.4%). The most common bacteria in 2006/07 and 2015/16 were coagulase-negative Staphylococci (44.3 vs. 49.6%), Pseudomonas aeruginosa (18.6 vs. 13.9%), Staphylococcus aureus (10 vs. 16.5%), Corynebacterium spp. (8.6 vs. 5.2%), and Moraxella spp. (7.1 vs. 9.6%). Candida parapsilosis was the most common fungal isolate in both groups (25 vs. 33.3%). Between 2006 and 2016, fungal keratitis was found in 37 eyes (Candida spp. n = 11, Fusarium spp. n = 11, Aspergillus spp. n = 5, others n = 10). All patients with Fusarium spp. keratitis had a history of wearing contact lenses. Conclusion The most commonly isolated bacterial organisms were Staphylococci and Pseudomonas spp., whereas fungal keratitis was mainly due to Candida spp. or Fusarium spp. No relevant variation in causative pathogens was observed between the two time periods.

A single-centre retrospective observational study of fungal keratitis in Poland with a review of findings in Europe

“…The following search terms were used: "fungal keratitis", "keratomycosis", "pattern of fungal keratitis in Europe" and "epidemiology of mycotic keratitis". Ten published articles met the inclusion criteria [8][9][10][11][12][13][14][15][16][17][18]. The literature data was analysed in terms of gender, age, causes of fungal keratitis, and treatment outcomes in order to identify similarities and differences, and to enable further comparisons with the results obtained at the Department of Ophthalmology of the Railway Hospital in Katowice.…”

Profiling of Diagnostic Information of and Latent Susceptibility to Bacterial Keratitis From the Perspective of Ocular Bacterial Microbiota

“…BK accounts for over 90% of microbial keratitis in temperate regions ( Ong and Corbett, 2015 ). Under a conservative estimate, there are 1.5–2.0 million cases of monocular blindness annually associated with this disease ( Shah et al., 2011 ; Ong and Corbett, 2015 ; Bograd et al., 2019 )…”

Anterior Segment Optical Coherence Tomography in the Early Management of Microbial Keratitis: A Cross-Sectional Study

“…It can progress rapidly and cause severe visual impairment, thus being considered a medical emergency. 6 7,8 Slit-lamp examination allows the lesion to be located and measured vertically and horizontally; however, it does not characterize the stromal edema and is examiner-dependent. 9 First described in 1994 by Izatt et al, 10 anterior segment optical coherence tomography (AS-OCT) is a noncontact optical device that provides cross-sectional images of internal structures in biological tissues such as the cornea and anterior chamber.…”