Microbiological and epidemiological study of infectious keratitis in children and adolescents

Yu, Maria Cecília Zorat; Höfling-Lima, Ana Luísa; Furtado, Guilherme Henrique Campos

doi:10.5935/0004-2749.20160084

Cited by 16 publications

(6 citation statements)

References 18 publications

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“…We noted a male preponderance similar to other data from India, 9–11 Middle East, 12 South America, 13 and North America. 14 However, in Hong Kong, MK occurred more commonly in girls.…”

Section: Discussionsupporting

confidence: 90%

Pediatric Microbial Keratitis: Identification of Clinical Biomarkers for Prognosis and Outcome of 218 Cases From 2009 to 2019

Zazzo

Rajan

Dureja

et al. 2021

Cornea

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The aim of this study was to analyze the risk factors, microbiological profile, and treatment efficacy in pediatric microbial keratitis (MK) and to identify clinical biomarkers prognosticating outcome. Methods:A retrospective analysis was conducted from patients younger than 16 years with MK-excluding viral, marginal, or interstitial keratitis. Data pertaining to predisposing factors, symptom duration, prior treatment, ulcer characteristics, microbiological profile, time to resolution, and final outcome were recorded. Statistical analysis was performed. The mixed-effects linear regression model with random intercept was used to evaluate factors affecting time to resolution.Results: Among 218 episodes of 215 pediatric patients with MK, the geometric mean of central [median 3 mm, interquartile range (IQR) 1-4.3 mm] and peripheral ulcers (median 1 mm, IQR 1-2.5 mm) was significantly different (P , 0.0001). Organisms identified were bacteria (56.9%), fungi (31.5%), and acanthamoebae (2.3%). Of 172 cases (78.8%), which resolved in a median resolution time of 22 days (IQR, 11-44 days), 107 (81.6%) with absent/negative microbiology healed on empirical therapy. On multivariate analysis, peripheral ulcers and geo-metric mean ulcer size affected time to resolution. Significantly higher percentage of eyes, which worsened or perforated, were on topical steroids compared with those which healed (31.8% vs. 9.2%, P = 0.0061).Conclusions: Good outcome even in culture negative cases suggests empirical therapy may be instituted for nonsevere peripheral pediatric MK; however, the importance of a microbiological workup cannot be underscored enough. Ulcer location and geometric mean size of ulcer may be used as clinical prognostic markers for resolution.

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“…We noted a male preponderance similar to other data from India, 9–11 Middle East, 12 South America, 13 and North America. 14 However, in Hong Kong, MK occurred more commonly in girls.…”

Section: Discussionsupporting

confidence: 90%

Pediatric Microbial Keratitis: Identification of Clinical Biomarkers for Prognosis and Outcome of 218 Cases From 2009 to 2019

Zazzo

Rajan

Dureja

et al. 2021

Cornea

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“…In agreement with our findings, several studies have reported a gram-negative predominance, with the most common isolate being Pseudomonas aeruginosa which was associated with contact lens use, 9 , 11 , 16 yet, other studies reported contrasting results. 11 , 13 , 14 In Saudi, a gram-positive predominance was reported with Streptococcus pneumonia being the most common isolate, followed by Staphylococcus epidermidis , whereas Pseudomonas aeruginosa was found to be the predominant isolate of gram-negative and it was associated with contact lens-related microbial keratitis, 5 which seems consistent with the varying frequency of predisposing factors among different populations; as Pseudomonal keratitis was associated with contact lens, whereas Staphylococcus aureus was associated with trauma.…”

Section: Discussionmentioning

confidence: 63%

Pediatric Non-Viral Microbial Keratitis: Predisposing Factors, Microbiological Profile, Treatment Modalities, and Visual Outcome

Alwohaibi¹,

Bamashmoos

Somali³

2022

OPTH

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Purpose To describe the predisposing factors, causative organisms, treatment modalities, and visual outcomes of childhood non-viral microbial keratitis in our region. Patients and Methods All cases with the clinical or microbiological diagnosis of non-viral microbial keratitis in patients ≤18 years presenting to Dhahran Eye specialist Hospital, a tertiary eye care hospital in Dhahran, Eastern Province, Saudi Arabia, between 2010 and 2020 were included. A retrospective chart review was conducted. Demographic data, predisposing factors, clinical characteristics, isolated microorganisms, and visual outcomes were recorded. Results Fifty-nine patients were included in this study, of which three cases were bilateral. The mean age was 9.3 ± 6.3 years (range: 14 days - 18 years). Predisposing factors were identified in 89.8% (n=53) of cases. Contact lens wear was the leading cause 35.6% (n=21), followed by trauma 27.1% (n=16), ocular diseases 11.9% (n=7), systemic diseases 10.2% (n=6), and ocular surgery 5.1% (n=3). Out of all cases, 66.1% (n=39) have undergone corneal scraping, out of which 43.6% (n=17) showed positive growth. Gram-negative organisms accounted for 47.1% (n=8) isolates of all culture-positive cases. Pseudomonas aeruginosa was the most common pure isolate, which accounted for 41.2% (n=7) of culture-positive cases, followed by Staphylococcus aureus 11.8% (n=2). The most common complication was corneal scar in 71.2% (n=42). Nineteen (32.2%) patients had poor outcome. Seven patients (11.9%) required further intervention, these included penetrating keratoplasty (n=1), deep lamellar keratoplasty (n=3), Photorefractive keratectomy (n=2), and Phototherapeutic keratectomy (n=1). Conclusion Childhood non-viral microbial keratitis is uncommon; however, it carries significant risks. Most cases were associated with preventable risk factors, with contact lens wear being the leading cause. Early detection and management are mandatory to reduce the risk of vision-threatening complications. The difficulty in assessment should not jeopardize proper evaluation and management of suspected cases.

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“…Bacterial keratitis and its sequelae are important causes of ocular morbidity and blindness in developing countries (15). Microbial keratitis affects approximately 5 in 10,000 wearers (1).…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Bacterial Keratitis in Contact Lens Wearing Female Medical Students in Sana'a, Yemen

Kaid Al-Mohani

2023

JNFP

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Bacterial keratitis is bacterial infection of the cornea of eye and it is the fifth leading cause of blindness. Contact lens wearing is the most critical risk factor for microbial keratitis in developed countries and developing countries.In Yemen, females wear contact lens mainly for cosmetic purposes and there are no reliable statistics documenting the prevalence of Bacterial keratitis among contact lens wear especially among females. Amis: To find the prevalence of Bacterial keratitis and associated risk factors among female medical students at the National University who wear Contact Lenses in Sana'a city, Yemen. Methods: A cross-sectional structured questionnaire survey of 50 elements conducted to evaluate the behavioral and socio-demographic data.Corneal specimens were collected and cultured to isolate bacteria that cause keratitis. Results: the results revealed that, the prevalence rate of bacterial keratitis among participants was 72%. Staphylococcus aurous and coagulase negative staphylococci were the most common agents of bacterial keratitis.There were statistically significant differences between bacterial keratitis and age, extended wear contact lens wear, sharing contact lens with others, cleaning of contact lens and use eye drops. Conclusion: The major risk factors for bacterial keratitis include prolonged wear of contact lenses, sharing of lenses with others and poor hygiene practices when handling contact lenses. Female students aged 38–42 are the most at-risk group. Bacterial keratitis is preventable diseases.

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Microbiological and epidemiological study of infectious keratitis in children and adolescents

Cited by 16 publications

References 18 publications

Pediatric Microbial Keratitis: Identification of Clinical Biomarkers for Prognosis and Outcome of 218 Cases From 2009 to 2019

Pediatric Microbial Keratitis: Identification of Clinical Biomarkers for Prognosis and Outcome of 218 Cases From 2009 to 2019

Pediatric Non-Viral Microbial Keratitis: Predisposing Factors, Microbiological Profile, Treatment Modalities, and Visual Outcome

Prevalence of Bacterial Keratitis in Contact Lens Wearing Female Medical Students in Sana'a, Yemen

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