Demographic and Predisposing Factors in Corneal Ulceration

Musch, David C.; Sugar, Alan; Meyer, Roger F.

doi:10.1001/archopht.1983.01040020547007

Cited by 118 publications

(59 citation statements)

References 6 publications

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“…If clinical response was unsatisfactory, antimicrobial therapy was changed either by adding tobramycin (0.3%) or as per culture and antibiotic susceptibility reports, if available. 11 Patients with any of the following conditions, including extremely thin cornea, impending or frank perforation, progressive or unresponsive disease, and endophthalmitis, underwent keratoplasty to remove the focal infection and restore visual acuity.…”

Section: Treatmentmentioning

confidence: 50%

Paediatric bacterial keratitis cases in Shanghai: microbiological profile, antibiotic susceptibility and visual outcomes

Hong

Chen

Sun

et al. 2012

Eye

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Purpose The purpose of this study was to review the microbiological profile, in vitro antibiotic susceptibility and visual outcomes of paediatric microbial keratitis in Shanghai, China over the past 6 years. Methods Medical records of patients aged r16 years were reviewed, who were diagnosed as having bacterial keratitis between 1 January 2005 and 31 December 2010. Bacterial culture results and in vitro antibiotic susceptibility were analysed. A logistic regression analysis was conducted to evaluate the relationship between visual impairment and possible risk factors. Results Eighty consecutive cases of paediatric bacterial keratitis cases were included, among which 59 were identified as having positive culture. Staphylococcus epidermidis was the most commonly isolated organism (n ¼ 23; 39.0%), followed by Streptococcus pneumoniae (n ¼ 11; 18.6%) and Pseudomonas aeruginosa (n ¼ 6; 10.2%). Antibiotic sensitivities revealed that tested bacteria had low resistance rates to fluoroquinolones and aminoglycosides (8.3-18.4% and 12.5-24.4%, respectively). Multivariate logistic regression analysis proved that visual impairment was significantly associated with Gram-negative bacterial infection (odds ratio (OR) ¼ 7.626; P ¼ 0.043) and an increasing number of resistant antibiotics (OR ¼ 0.385; P ¼ 0.040). Conclusions S. epidermidis was the most common isolated organism in Shanghai paediatric keratitis. The fluoroquinolones and aminoglycosides remained good choices for treating these patients. Gram-negative bacterial infection and an increasing number of resistant antibiotics were associated with worse visual prognoses in paediatric keratitis.

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Section: Treatmentmentioning

confidence: 50%

Paediatric bacterial keratitis cases in Shanghai: microbiological profile, antibiotic susceptibility and visual outcomes

Hong

Chen

Sun

et al. 2012

Eye

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“…Although it is known that the antimicrobial activity of some defensins is compromised by high salt concentrations, 23 which is in keeping with the observation that the compromised ocular surface of patients with dry eye caused by Sjogren syndrome is at risk for microbial infection. 24 However, in addition to their antimicrobial effects, defensins are known to modulate the behavior of mammalian cells; thus, even if hyperosmolality-induced defensin expression cannot contribute to antimicrobial protection, the defensins may have other effects on ocular surface epithelial cells such as promoting migration and proliferation. 25 Therefore, the goal of this study was to investigate if differential expression of β-defensins by HCECs in culture was observed under hyperosmolar growth conditions.…”

mentioning

confidence: 43%

Effect of Hyperosmolality on β-Defensin Gene Expression by Human Corneal Epithelial Cells

Narayanan

Manning²,

Proske³

et al. 2006

Cornea

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Purpose-As human β-defensins (hBD) are important antimicrobial peptides at epithelial surfaces, including the ocular surface, we tested the effect of hyperosmolar conditions on the expression of these peptides by human corneal epithelial cells (HCECs).Methods-Simian virus 40-transformed HCECs (n = 5) or primary cultured HCECs (n = 5) were treated with serum-free media or serum-free hyperosmolar (400-500 mOsm/kg) media for 24 hours or serum-free 500 mOsm/kg media for 12 to 48 hours. The effect of hyperosmolality on interleukin-1β (IL-1β)-induced hBD-2 expression was also tested. IL-6 expression was studied as a marker of IL-1β function. Expression of hBD-1, -2, and -3 and IL-6 mRNA was detected by reverse transcription-polymerase chain reaction (RT-PCR). The levels of active IL-1β (culture supernatants and cell lysates) and pro-IL-1β (cell lysates) were detected by enzyme-linked immunosorbent assay.Results-HCECs constitutively expressed hBD-1 and -3 but not hBD-2. Hyperosmolar media had no effect on the basal expression of hBD-1 or -3 and did not induce the expression of hBD-2. Treatment with 500 mOsm/kg media for 24 hours decreased the ability of IL-1β to upregulate hBD-2 and IL-6 expression. Active or pro-IL-1β was not detected in any cell culture sample.Conclusion-Our results suggest that the hyperosmolar environment observed in diseases such as dry eye does not alter defensin expression. However, a hyperosmolar environment may influence cytokine function in ocular surface cells and thus affect their response to injury and inflammation. Keywords hyperosmolality; human β-defensins; corneal epithelium; cytokines Hyperosmolality at the ocular surface is a characteristic of diseases such as dry eye and diabetes mellitus. The normal osmolality of the tear fluid is approximately 300 mOsm/kg, 1 whereas the suggested "gold standard" diagnostic of dry eye is 312 mOsm/kg or greater. 2 It has been proposed that tear fluid hyperosmolality occurs because of either normal tear evaporation associated with reduced tear flow or excessive tear evaporation with a normal tear flow. 3 The hyperosmolar tear film is thought to affect ocular surface epithelial function and differentiation in dry eye disease, with osmolalities as high as 417 mOsm/kg being reported. 1,4,5 Also, Aragona et al 6 showed that type 1 diabetic patients had a significantly higher mean tear osmolality (332.2 ± 18.3 mOsm/L), poor tear stability, altered tear function, and symptoms of ocular irritation akin to patients with dry eye than normal patients. Hyperosmolality in diabetes mellitus is probably attributable to increased levels of tear glucose seen in patients with both types 1 and 2. 7

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“…[1][2][3] Predisposing factors have included ocular surface disease, ocular trauma, contact lens wear, systemic diseases, and ocular surgery. 2,[4][5][6][7] In a working age population, the two major preventable predisposing factors are ocular trauma and contact lens wear, 5,7 each accounting for 1/3 of new cases presenting to a tertiary referral centre in Australia.…”

mentioning

confidence: 44%

Contact lens-related microbial keratitis: how have epidemiology and genetics helped us with pathogenesis and prophylaxis

Stapleton

Carnt

2011

Eye

238

189

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Demographic and Predisposing Factors in Corneal Ulceration

Cited by 118 publications

References 6 publications

Paediatric bacterial keratitis cases in Shanghai: microbiological profile, antibiotic susceptibility and visual outcomes

Paediatric bacterial keratitis cases in Shanghai: microbiological profile, antibiotic susceptibility and visual outcomes

Effect of Hyperosmolality on β-Defensin Gene Expression by Human Corneal Epithelial Cells

Contact lens-related microbial keratitis: how have epidemiology and genetics helped us with pathogenesis and prophylaxis

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