Bacterial keratitis: predisposing factors, clinical and microbiological review of 300 cases

Abstract

Aim: To identify predisposing factors and to define clinical and microbiological characteristics of bacterial keratitis in current practice. Methods: A retrospective analysis of the hospital records of patients presenting with bacterial keratitis and treated at the Quinze-Vingts National Center of Ophthalmology, Paris, France, was performed during a 20 month period. A bacterial keratitis was defined as a suppurative corneal infiltrate and overlying epithelial defect associated with presence of bacteria on corneal scraping and/or that was cured with antibiotic therapy. Risk factors, clinical and microbiological data were collected. Results: 300 cases (291 patients) of presumed bacterial keratitis were included. Potential predisposing factors, usually multiple, were identified in 90.6% of cases. Contact lens wear was the main risk factor (50.3%). Trauma or a history of keratopathy was found in 15% and 21% of cases, respectively. An organism was identified in 201 eyes (68%). 83% of the infections involved Gram positive bacteria, 17% involved Gram negative bacteria, and 2% were polymicrobial. Gram negative bacteria were associated with severe anterior chamber inflammation (p=0.004), as well as greater surface of infiltrates (p=0.01). 99% of ulcers resolved with treatment, but only 60% of patients had visual acuity better than the level at admission, and 5% had very poor visual outcome. Conclusions: Contact lens wear is the most important risk factor. Most community acquired bacterial ulcers resolve with appropriate treatment.

Study of Conjunctival Flora in Patients after Peripheral Blood Stem Cell Transplantation and its Correlation with Tear Secretion

“…Some studies indicated that immunocompromised status such as diabetes mellitus, [5,11] administration of immunosuppressive agents [11] and HIV infection, [12] are predisposing factors of microbial keratitis. Consequently, we presumed that the immunosuppressive treatment posthematopoietic stem cell transplantation may also increase the risk of infectious keratitis.…”

Contact Lens-Related Infectious Keratitis: Review of 29 Cases

“…This period was less than or equal to 7 days in 69% of cases. In the literature, the average consultation period was 4.6 days in the Netherlands as discussed by Hoddenbach [1], 2 days in France as cited by Bourcier [13] and 5 days in a Moroccan study realized by Benhmidoune and et al [3]. The corneal abscess in our series was unilateral in all cases (100%).…”

Investigating Infectious Keratitis

“…If no laboratory-skilled assistant can be present at the time of sampling, basic microbiologic training should be given to the ophthalmologist, and fresh media should be provided as required. Data showing a rate of definitive diagnosis (70.4%) that is among the highest of those published (1,2,3) are the basis for this encouragement.…”