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Microbial characteristics of posttraumatic infective keratitis

Microbial characteristics of posttraumatic infective keratitis

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Article Type: ORIGINAL RESEARCH ARTICLE

Article Subject: Cornea

DOI:10.5301/ejo.5001009

Authors

Blanche X. Lim, Victor T.C. Koh, Manotosh Ray

Abstract

Purpose

To determine the demographics, risk factors, clinical and microbiological characteristics, and treatment outcome of posttraumatic infective keratitis.

Methods

Consecutive patients with posttraumatic infective keratitis presenting to the Ophthalmology Department of a tertiary referral hospital in Singapore between March 2012 and March 2016 were prospectively identified. A standardized data collection form was used to document patient demographics, microbiological diagnosis, antibiotic sensitivity, and pretreatment and posttreatment ocular characteristics. Any contact lens-induced keratitis was excluded from the study.

Results

In total, 26 patients were included for analysis. The mean age was 40.0 years (SD ± 19.4) and 84.6% of the patients were male. The majority of the patients (69.2%, n = 18) had sustained work-related injury in their eyes. Gram-negative organisms were predominant isolates (75.0%, n = 12) in culture-positive corneal scrapings (n = 16). Pan-sensitive Pseudomonas aeruginosa was the commonest organism isolated among the culture-positive cases (56.2%, n = 9). Three patients (18.7%) had developed fungal keratitis and Acanthamoeba was isolated in 1 patient (6.2%) with polymicrobial keratitis. Infections resolved with medical treatment in 22 eyes (84.6%) and 4 eyes (15.3%) required therapeutic corneal transplantation.

Conclusions

A shift of practice in posttraumatic infective keratitis should be considered in tropical countries to include Gram-negative cover. Work safety practices with vigilance in initiating treatment and education by front-line physicians such as ophthalmology and general practitioners should be reinforced.

Article History

Disclosures

Financial support: No financial support was received for this submission.
Conflict of interest: None of the authors has conflict of interest with this submission.

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Authors

Affiliations

  • Department of Ophthalmology, National University Health System, Singapore - Singapore
  • Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore - Singapore

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