Clinical Features and Antibiotic Susceptibility of Culture-proven Infectious Keratitis: a Multicenter 10-year Study

You, In Cheon; Lee, Sang-Bumm; Seo, Kyoung Yul; Kim, Mee Kum; Yoon, Kyung-Chul; Koh, Jae Wong; Lee, Ji Eun; Kim, Seong-Jae

doi:10.3341/jkos.2021.62.4.447

Cited by 6 publications

(2 citation statements)

References 21 publications

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“…This demonstrates a notable increase in frequency in the Jeju region over the past 6 years, marking a difference from the distribution of fungal keratitis found in Korea. 34 Colletotrichum fungi, belonging to the pigmented hyphae group among fungi, are relatively common in tropical and subtropical regions, suggesting an association with Jeju’s regional characteristics. 35–37 Therefore, when encountering patients with fungal keratitis in Jeju, it is crucial to consider the possibility of diagnosing Colletotrichum as one of the causative agents.…”

Section: Discussionmentioning

confidence: 99%

Microbial keratitis in the subtropical region of Korea: a comprehensive 12-year retrospective review at a single referral center

Ji,

Park,

et al. 2024

BMJ Open

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ObjectivesTo investigate the epidemiological characteristics and clinical outcomes of culture-proven bacterial and fungal keratitis at a single tertiary referral centre on Jeju Island, South Korea.DesignA retrospective study design.SettingData from a solitary referral centre on Jeju Island spanning January 2011 to December 2022.ParticipantsAmong the 245 patients clinically diagnosed with infectious microbial keratitis, 110 individuals had culture-positive results.Primary and secondary outcome measuresThe primary outcome was the identification of causative microbial profiles and epidemiological characteristics, while the secondary outcome was the correlation of these factors with treatment outcomes.ResultsOf 245 patients, 110 (44.9%) had culture-positive infectious keratitis, showing 69 bacterial, 32 fungal, 4 superimposed bacterial and 5 cases with coinfection by bacteria and fungus. The most common pathogen wasPseudomonasspecies in 14.4% of the bacterial keratitis cases, followed byStaphylococcus epidermidis(9%),Staphylococcus aureus(8%) and Moraxella species (7%). The total treatment success rate for bacterial keratitis was 67.5%. The frequency of methicillin-resistantStaphylococcuson Jeju Island did increase during the study period. Fusarium species had the highest incidence at 22.2%, followed byCandida(16.7%) andColletotrichumspecies (11.1%). 56.7% of fungal keratitis patients were successfully treated. An initial large corneal lesion (>3 mm) showed a statistically significant association with treatment failure.ConclusionThe incidence ofMoraxellaandColletotrichumspecies in our study was higher than that reported in other districts with different climates and environments. The results reported here reflect the unique environmental features of Jeju Island, characterised by high humidity and temperatures.

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Section: Discussionmentioning

confidence: 99%

Microbial keratitis in the subtropical region of Korea: a comprehensive 12-year retrospective review at a single referral center

Ji,

Park,

et al. 2024

BMJ Open

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“…Two tertiary hospitals in this study located in Jeolla Province, south area of South Korea, subtropical area. Two hospitals were most frequently reported hospitals of fungal keratitis in South Korea, between 2008 and 2017 [22].…”

Section: Discussionmentioning

confidence: 99%

Clinical Comparison of Fusarium Keratitis according to the Initial Potassium Hydroxide (KOH) Smear: A Retrospective Study in South Korea

Kim

Yoon

et al. 2022

Journal of Ophthalmology

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Purpose. This study aimed to compare predisposing factors, clinical characteristics, treatment, and prognosis of Fusarium keratitis according to the result of the initial potassium hydroxide (KOH) smear. Methods. This is a retrospective study of cases with Fusarium keratitis between January 2000 and December 2019 at two tertiary hospitals in South Korea. Patients were divided into two groups depending on the KOH smear result (KOH-positive and KOH-negative group), and its clinical factors were analyzed. Results. Among 319 fungal keratitis, seventy-nine cases were identified with Fusarium keratitis. Forty-seven cases (59.5%) were negative in the initial KOH smear prior to their diagnosis. The most common predisposing factor for Fusarium keratitis was ocular trauma (55.7%). There were no significant differences in sex, occupation, ulcer size or shape, hypopyon, and initial visual acuity between the two groups. Differences were observed between the KOH-positive group and the KOH-negative group in terms of deep corneal infiltration (50.0% vs. 78.7%, p = 0.008 ) and evisceration treatment (3.1% vs. 25.5%, p = 0.008 ). The delayed time to initiate antifungal eye drops was longer in the KOH-negative group (1.13 ± 0.49 vs. 3.93 ± 4.89, p = 0.002 ). Only the KOH-negative group combined bacterial infection. The significant risk factors for poor clinical outcomes were the central corneal lesion (odds ratio (OR) 3.50, p = 0.047 ), a large ulcer size (size ≥ 7.5 mm2) (OR 4.98, p = 0.009 ), and endothelial plaque (OR 7.00, p = 0.031 ). Conclusion. Initial KOH-negative patients often needed evisceration and had worse final visual outcomes. The delay of prompt initiation of antifungal treatment and combined bacterial infection result in a poor prognosis. This study highlights the initial KOH effect on early diagnosis and early treatment of Fusarium keratitis.

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Comparative Clinical Analysis of Polymicrobial and Monomicrobial Bacterial Keratitis

Baek¹,

Cho²,

Lee³

2021

J Korean Ophthalmol Soc

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Purpose: We comparatively analyzed the microbiological profiles, predisposing factors, clinical aspects, and treatment outcomes of patients with polymicrobial and monomicrobial bacterial keratitis.Methods: A total of 194 cases of culture-proven bacterial keratitis treated between January 2007 and December 2016 were reviewed. Microbiological profiles, the epidemiology, predisposing factors, clinical characteristics, and treatment outcomes were compared between the polymicrobial group (polymicrobial bacterial keratitis [PBK]; 29 eyes, 62 isolates) and monomicrobial (monomicrobial bacterial keratitis [MBK]; 165 eyes, 165 isolates) group.Results: The most common isolates were Enterobacter (24%) in the PBK group and Staphylococcus (22%) in the MBK group. There were no significant differences between the two groups in previous ocular surface disease, previous ocular surgery, prior topical steroid use, epithelial defect size, and hypopyon. Age ≥60 years (PBK vs. MBK, 31% vs. 51%, p = 0.048), symptom duration (4.7 days vs. 8.0 days, p = 0.009), and contact lens use (34% vs. 18%, p = 0.036) were significantly different between the two groups. Regarding treatment outcomes, epithelial healing time ≥10 days, the final best-corrected visual acuity (BCVA), a need for surgical intervention, and the rate of poor clinical outcome were not significantly different between the two groups. Significant risk factors for a poor clinical outcome in all patients were an initial BCVA <0.1 (Z = 6.33, two-proportion Z-test), an epithelial defect size ≥5 mm2 (Z = 4.56), and previous ocular surface disease (Z = 4.36).Conclusions: Polymicrobial bacterial keratitis, compared to monomicrobial bacterial keratitis, was more significantly associated with younger age, contact lens use, and shorter symptom duration.

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Clinical Features and Antibiotic Susceptibility of Culture-proven Infectious Keratitis: a Multicenter 10-year Study

Cited by 6 publications

References 21 publications

Microbial keratitis in the subtropical region of Korea: a comprehensive 12-year retrospective review at a single referral center

Microbial keratitis in the subtropical region of Korea: a comprehensive 12-year retrospective review at a single referral center

Clinical Comparison of Fusarium Keratitis according to the Initial Potassium Hydroxide (KOH) Smear: A Retrospective Study in South Korea

Comparative Clinical Analysis of Polymicrobial and Monomicrobial Bacterial Keratitis

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