alexa Bacterial keratitis: predisposing factors, clinical and microbiological review of 300 cases.


Journal of Clinical & Experimental Ophthalmology

Author(s): Bourcier T, Thomas F, Borderie V, Chaumeil C, Laroche L

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Abstract AIM: To identify predisposing factors and to define clinical and microbiological characteristics of bacterial keratitis in current practice. METHODS: A retrospective analysis of the hospital records of patients presenting with bacterial keratitis and treated at the Quinze-Vingts National Center of Ophthalmology, Paris, France, was performed during a 20 month period. A bacterial keratitis was defined as a suppurative corneal infiltrate and overlying epithelial defect associated with presence of bacteria on corneal scraping and/or that was cured with antibiotic therapy. Risk factors, clinical and microbiological data were collected. RESULTS: 300 cases (291 patients) of presumed bacterial keratitis were included. Potential predisposing factors, usually multiple, were identified in 90.6\% of cases. Contact lens wear was the main risk factor (50.3\%). Trauma or a history of keratopathy was found in 15\% and 21\% of cases, respectively. An organism was identified in 201 eyes (68\%). 83\% of the infections involved Gram positive bacteria, 17\% involved Gram negative bacteria, and 2\% were polymicrobial. Gram negative bacteria were associated with severe anterior chamber inflammation (p=0.004), as well as greater surface of infiltrates (p=0.01). 99\% of ulcers resolved with treatment, but only 60\% of patients had visual acuity better than the level at admission, and 5\% had very poor visual outcome. CONCLUSIONS: Contact lens wear is the most important risk factor. Most community acquired bacterial ulcers resolve with appropriate treatment.
This article was published in Br J Ophthalmol and referenced in Journal of Clinical & Experimental Ophthalmology

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