Comparison of culture-positive and culture-negative severe infectious keratitis leading to hospitalization: a tertiary referral center experience

Abstract

Aim: To compare the predisposing factors, surgical interventions, length of hospital stay (LOHS), and treatment outcomes of culture-positive (CP) versus culture-negative (CN) severe infectious keratitis (IK) resulting in hospitalization in a tertiary referral clinic. 
 Material and Method: We retrospectively reviewed the medical and microbiological records of 287 patients clinically diagnosed with severe keratitis over a 4-year period. 
 Results: Of 287 study participants, 141 (49.1%) had positive CP results. The most common ocular risk factor was a previous ocular surgery (45.6%), and keratoplasty was the first among these ocular surgeries (90.8%). Staphylococcus epidermidis (22.7%) was the most commonly isolated microorganism followed by fungi (17.7%). The initial and final visual acuities did not differ significantly between the CP and CN groups. Major and minor surgical interventions did not significantly differ between the groups (p=0.05). The rates of clear corneal graft in the CP group (p =0.002) were significantly higher than the rates of graft failure in the CN group (p=0.033). No significant difference was noted in the mean LOHS between groups (p=0.66). Logistic regression analyses showed that surgery during admission, S. epidermidis infection, and connective tissue diseases were independent risk factors for a prolonged hospital stay. 
 Conclusion: The initial and final visual acuities, surgical interventions, and LOHS were similar between the CP and CN groups. However, graft failure rates were significantly higher in patients with CN keratitis than in those with CP keratitis.

Assessment of Direct Costs of Admission Due to Presumed Microbial Keratitis in a Tertiary Referral Hospital in Thailand: A 7-Year Retrospective Study

“…[31][32][33] These discrepancies may be attributed to variations in demographic data and risk factors among the study populations. 29,31 In our study, we found that the median direct cost for treating a single episode of severe keratitis was US$10,840.17, with an interquartile range spanning from US$5866.56 to US$24,172.28. Notably, there was no significant difference in direct costs observed between cases with negative cultures and those with positive cultures.…”

“… 31–33 These discrepancies may be attributed to variations in demographic data and risk factors among the study populations. 29 , 31 …”

“…These results are in line with some previous studies that also compared culture results. 29,30 However, it's worth noting that certain other studies have reported a higher need for surgical intervention in the culture-positive group compared to the culture-negative group. [31][32][33] These discrepancies may be attributed to variations in demographic data and risk factors among the study populations.…”