Risk Factors and Causative Organisms in Microbial Keratitis

Green, Matthew; Apel, Andrew; Stapleton, Fiona

doi:10.1097/ico.0b013e318156caf2

Cited by 451 publications

(381 citation statements)

References 21 publications

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“…[15][16][17][18][19][20] In the current study, postoperative bullous keratoplasty (9/14, 64.3%) was the major risk factor for keratitis due to ocular surface diseases with recurrent erosion of the epithelium. 21,22 Fusarium infection is the most common pathogen leading to cornea perforation (28.8%), followed by P. aeruginosa keratitis (21.4%). This is consistent with the literature that Pseudomonas and Fusarium keratitis are the most virulent and rapid progressive pathogens.…”

Section: Resultsmentioning

confidence: 99%

Eye preservation tectonic graft using glycerol-preserved donor cornea

Hc¹,

Sj²,

Chao³

2012

Eye

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Aims To report the surgical outcome of tectonic graft using glycerol-preserved donor corneas to treat perforated keratitis. Methods The medical records were reviewed of all patients treated for perforated keratitis using glycerol-preserved corneas at a single institution between 1 July 2004 and 31 June 2010. The clinical features, precipitating factors, adjuvant therapies, and therapeutic outcomes were analyzed. Success was defined as re-epithelialization of the ocular surface without evisceration. Results Fourteen eyes from 14 patients (6 male and 8 female) were included. Age ranged from 58 to 84 years (average, 70.71±8.52 years) and the follow-up time ranged from 7 to 56 months (mean, 25.35 ± 16.84 months). The culture results showed five bacterial infections, five cases of fungal keratitis, and one mixed infection; the culture results were negative for three patients. Satisfactory anatomical integrity was obtained in eight grafts (57.14%) that healed with neovascularization. Six grafts (48.85%) showed delayed re-epithelialization and were repaired with conjunctival flaps to maintain ocular surface integrity. Three patients developed secondary glaucoma and received trans-scleral cyclophotocoagulation. Thirteen patients had satisfactory anatomical integrity without evisceration or exenteration, while one patient received evisceration at 39-month follow-up because of intractable glaucoma. Conclusions Glycerol-preserved donor corneas combined with anterior vitrectomy with or without conjunctival flaps may be effective substitutes for evisceration surgery in patients with perforated keratitis.

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Section: Resultsmentioning

confidence: 99%

Eye preservation tectonic graft using glycerol-preserved donor cornea

Hc¹,

Sj²,

Chao³

2012

Eye

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“…Clinical presentation of bacterial keratitis include acute pain, redness, photophobia and corneal ulceration [179]. Pseudomonas ulcers are more severe at presentation than other bacterial ulcers and are often difficult to treat, resulting in worse visual outcome than other bacterial ulcers [56,183].…”

Section: Bacterial Keratitismentioning

confidence: 99%

Pathogenesis of microbial keratitis

Lakhundi

Siddiqui

Khan

2017

Microbial Pathogenesis

181

121

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Microbial keratitis is a sight-threatening ocular infection caused by bacteria, fungi, and protist pathogens. Epithelial defects and injuries are key predisposing factors making the eye susceptible to corneal pathogens. Among bacterial pathogens, the most common agents responsible for keratitis include Staphylococcus aureus, Pseudomonas aeruginosa, Streptococcus pneumonia and Serratia species. Fungal agents of corneal infections include both filamentous as well as yeast, including Fusarium, Aspergillus, Phaeohyphomycetes, Curvularia, Paecilomyces, Scedosporium and Candida species, while in protists, Acanthamoeba spp. are responsible for causing ocular disease. Clinical features include redness, pain, tearing, blur vision and inflammation but symptoms vary depending on the causative agent. The underlying molecular mechanisms associated with microbial pathogenesis include virulence factors as well as the host factors that aid in the progression of keratitis, resulting in damage to the ocular tissue. The treatment therefore should focus not only on the elimination of the culprit but also on the neutralization of virulence factors to minimize the damage, in addition to repairing the damaged tissue. A complete understanding of the pathogenesis of microbial keratitis will lead to the rational development of therapeutic interventions. This is a timely review of our current understanding of the advances made in this field in a comprehensible manner. Coupled with the recently available genome sequence information and high throughput genomics technology, and the availability of innovative approaches, this will stimulate interest in this field.

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“…The prevalence of ocular trauma varied considerably among the studies on the elderly, from 3.7 to 43.6% (17,26,(28)(29) , but was relatively constant in the age-independent series, ranging from 16 to 26.6% (32)(33)(34)(35) . Contact lens wear was found in only 3.0% of cases, like the already mentioned studies with the exception of van der Meulen et al (29) , which found 13.0%.…”

Section: Predisposing Factorsmentioning

confidence: 99%

“…The prevalence of this predisposing factor in recent age-independent series of infectious keratitis varied from 11 to 17% (32)(33)(34)(35) , suggesting that such variable is more frequent in the elderly.…”

Section: Predisposing Factorsmentioning

confidence: 99%

Microbial keratitis in the elderly: a 32-year review

Passos¹,

Cariello²,

Yu³

et al. 2010

Arq. Bras. Oftalmol.

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Purpose: To describe the demographic characteristics, associated factors and causative agents of infectious keratitis in the elderly in a tertiary referral center in São Paulo, Brazil. Methods: A retrospective review of all patients aged 60 years and over with a presumptive diagnosis of infectious keratitis who had material collected for microbiological analysis, between the years 1975 and 2007 (32-year span). Results: From a total of 7,060 age-independent cases of microbial keratitis, 1,545 cases in the elderly were reviewed, which had a mean age of 71.0 ± 7.8 years, ranging from 60 to 101 years. There were 707 males (45.6%) and 838 females (54.3%). Associated factors were: past ocular surgery (25.1%), ocular trauma (7.2%) and contact lens use (3.0%). Bacterioscopy was positive in 40.5% of cases. Culture positivity for any agent was 53.5% (bacteria 47.0%, fungi 6.1%, Acanthamoeba 0.4%). The most frequent bacteria were the grampositive cocci (mostly coagulase-negative Staphylococci) and gram-negative bacilli (mostly the genera Pseudomonas, Moraxella and Proteus), while the most frequent fungi were the filamentous (mostly the genus Fusarium). Conclusions: This study represents a large series of microbial keratitis in the elderly in a single referral center. The most important factor associated with this condition in the elderly was past ocular surgery. The most frequent causative agents were bacteria, especially gram-positive cocci and gram-negative bacilli. Keywords

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Risk Factors and Causative Organisms in Microbial Keratitis

Abstract: In this series, the most common risk factor for keratitis was contact lens wear and the most commonly isolated organism was P. aeruginosa.

Cited by 451 publications

References 21 publications

Eye preservation tectonic graft using glycerol-preserved donor cornea

Eye preservation tectonic graft using glycerol-preserved donor cornea

Pathogenesis of microbial keratitis

Microbial keratitis in the elderly: a 32-year review

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