Infectious keratitis caused by Klebsiella spp.: predisposing factors, presentation, and management

Abstract

To study predisposing factors, clinical presentation and management strategies for klebsiella keratitis. MethodsA retrospective case review was performed on clinical records of culture-proven klebsiella keratitis cases in a tertiary referral center over an 8-year period (from 2012 to 2020). ResultsThirty eight episodes of culture-proven klebsiella keratitis were identi ed in 37 patients. The mean age of the patients was 62.9 years (range, 24-101).. Multiple predisposing factors were identi ed in 33 eyes including history of previous keratoplasty (n = 11) history of ocular trauma (n = 7), preexisting ocular surface disease(n = 7) and diabetes(n = 6). Corrected distance visual acuity (CDVA) was light perception (LP) in 16 patients, hand motion (HM) in 12, counting ngers (CF) at 50 centimeters in 5, CF at 1 meter in 1, CF at 2 m in 2 .One patient had a CDVA of 3/10. On initial examination Hypopyon was detected in 21 eyes. Descemet's membrane folds were present in 1 eye. Corneal thinning was identi ed in 20 eyes and perforation occurred in 4 patients. Corneal ulcer progressed to endophthalmitis in one patient.Microbiologic sensitivity testing showed that 89.5% isolates were sensitive to amikacin (34/38),88.9%sensitive to ceftazidime (32/36),94.4% were sensitive to gentamicin (34/36),97.2% sensitive to cipro oxacin (35/36), and 100% to levo oxacin (26/26).Ultimately, one or more surgical procedures was needed in 21 patients. ConclusionPrevious keratoplasty, history of ocular trauma, ocular surface disease and systemic disease such as diabetes are major risk factors for Klebsiella keratitis. In most of the patients, surgical and tectonic procedures were necessary to control the infection.

Interrupted Versus Running Sutures for Amniotic Membrane Fixation in Cases of Resistant Infected Corneal Ulcers

“…While Masoumi A and his group in a study of thirty eight cases of culture-proven klebsiella keratitis were identified in 37 patients. They identified Multiple predisposing factors; 33 eyes with history of ocular trauma (7 cases), preexisting ocular surface disease (7 cases) and diabetes (6 cases) history of previous keratoplasty (11 cases) [19]. In the study of Laspina,F and his group approximately half of cases had a history of trauma, the other half of these involved foreign bodies.…”