Risk factors, microbiological findings, and clinical outcomes in cases of microbial keratitis admitted to a tertiary referral center in ireland.

Hdl Handle:
http://hdl.handle.net/10147/207947
Title:
Risk factors, microbiological findings, and clinical outcomes in cases of microbial keratitis admitted to a tertiary referral center in ireland.
Authors:
Saeed, Ayman; D'Arcy, Fiona; Stack, Jim; Collum, Louis M; Power, William; Beatty, Stephen
Affiliation:
Waterford Regional Hospital, Waterford, Ireland. aymantalat@gmail.com
Citation:
Cornea. 2009 Apr;28(3):285-92.
Journal:
Cornea
Issue Date:
1-Feb-2012
URI:
http://hdl.handle.net/10147/207947
DOI:
10.1097/ICO.0b013e3181877a52
PubMed ID:
19387229
Abstract:
AIM: To identify the risk factors for, and to report the microbiological findings and clinical outcomes of, severe microbial keratitis (MK). METHODS: This was a retrospective study of all cases of presumed MK admitted to a tertiary referral center over a 2-year period (September 2001 to August 2003). Data recorded included demographic data, details relating to possible risk factors, results of microbiological studies, clinical findings at presentation, and clinical and visual outcomes. RESULTS: Ninety patients were admitted with a diagnosis of presumed MK during the study period. The mean age of patients was 45 +/- 32 years, and the male to female ratio was 47:43 (52.2%:47.7%). Predisposing risk factors for MK included contact lens wear (37; 41.1%), anterior segment disease (19; 21.1%), ocular trauma (13; 14.4%), systemic disease (5; 5.6%), and previous ocular surgery (1; 1.1%). Cultured organisms included gram-negative bacteria (17; 51.5%), gram-positive bacteria (11, 33.3%), acanthamoeba (2; 6.1%), and fungi (1; 3%). Visual acuity improved significantly after treatment [mean best-corrected visual acuity (+/-standard deviation) at presentation: 0.76 (+/-0.11); mean best-corrected visual acuity at last follow-up: 0.24 (+/-0.07); P < 0.001]. Secondary surgical procedures were required in 18 (20%) cases, and these included punctal cautery (1; 1.1%), tissue glue repair of corneal perforation (2; 2.2%), tarsorrhaphy (9; 9.9%), Botulinum toxin-induced ptosis (1; 1.1%), penetrating keratoplasty (3; 3.3%), and evisceration (2; 2.2%). CONCLUSIONS: Contact lens wear remains a significant risk factor for severe MK. MK remains a threat to vision and to the eye, but the majority of cases respond to prompt and appropriate antimicrobial therapy.
Language:
eng
MeSH:
Acanthamoeba Keratitis/diagnosis/*parasitology/therapy; Adolescent; Adult; Anti-Bacterial Agents/therapeutic use; Antiprotozoal Agents/therapeutic use; Child; Child, Preschool; Corneal Ulcer/diagnosis/*microbiology/therapy; Eye Infections, Bacterial/diagnosis/*microbiology/therapy; Eye Infections, Fungal/diagnosis/*microbiology/therapy; Female; Humans; Ireland; Male; Middle Aged; Ophthalmologic Surgical Procedures; Patient Admission; Referral and Consultation; Retrospective Studies; Risk Factors; Treatment Outcome; Visual Acuity
ISSN:
1536-4798 (Electronic); 0277-3740 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorSaeed, Aymanen_GB
dc.contributor.authorD'Arcy, Fionaen_GB
dc.contributor.authorStack, Jimen_GB
dc.contributor.authorCollum, Louis Men_GB
dc.contributor.authorPower, Williamen_GB
dc.contributor.authorBeatty, Stephenen_GB
dc.date.accessioned2012-02-01T10:52:14Z-
dc.date.available2012-02-01T10:52:14Z-
dc.date.issued2012-02-01T10:52:14Z-
dc.identifier.citationCornea. 2009 Apr;28(3):285-92.en_GB
dc.identifier.issn1536-4798 (Electronic)en_GB
dc.identifier.issn0277-3740 (Linking)en_GB
dc.identifier.pmid19387229en_GB
dc.identifier.doi10.1097/ICO.0b013e3181877a52en_GB
dc.identifier.urihttp://hdl.handle.net/10147/207947-
dc.description.abstractAIM: To identify the risk factors for, and to report the microbiological findings and clinical outcomes of, severe microbial keratitis (MK). METHODS: This was a retrospective study of all cases of presumed MK admitted to a tertiary referral center over a 2-year period (September 2001 to August 2003). Data recorded included demographic data, details relating to possible risk factors, results of microbiological studies, clinical findings at presentation, and clinical and visual outcomes. RESULTS: Ninety patients were admitted with a diagnosis of presumed MK during the study period. The mean age of patients was 45 +/- 32 years, and the male to female ratio was 47:43 (52.2%:47.7%). Predisposing risk factors for MK included contact lens wear (37; 41.1%), anterior segment disease (19; 21.1%), ocular trauma (13; 14.4%), systemic disease (5; 5.6%), and previous ocular surgery (1; 1.1%). Cultured organisms included gram-negative bacteria (17; 51.5%), gram-positive bacteria (11, 33.3%), acanthamoeba (2; 6.1%), and fungi (1; 3%). Visual acuity improved significantly after treatment [mean best-corrected visual acuity (+/-standard deviation) at presentation: 0.76 (+/-0.11); mean best-corrected visual acuity at last follow-up: 0.24 (+/-0.07); P < 0.001]. Secondary surgical procedures were required in 18 (20%) cases, and these included punctal cautery (1; 1.1%), tissue glue repair of corneal perforation (2; 2.2%), tarsorrhaphy (9; 9.9%), Botulinum toxin-induced ptosis (1; 1.1%), penetrating keratoplasty (3; 3.3%), and evisceration (2; 2.2%). CONCLUSIONS: Contact lens wear remains a significant risk factor for severe MK. MK remains a threat to vision and to the eye, but the majority of cases respond to prompt and appropriate antimicrobial therapy.en_GB
dc.language.isoengen_GB
dc.subject.meshAcanthamoeba Keratitis/diagnosis/*parasitology/therapyen_GB
dc.subject.meshAdolescenten_GB
dc.subject.meshAdulten_GB
dc.subject.meshAnti-Bacterial Agents/therapeutic useen_GB
dc.subject.meshAntiprotozoal Agents/therapeutic useen_GB
dc.subject.meshChilden_GB
dc.subject.meshChild, Preschoolen_GB
dc.subject.meshCorneal Ulcer/diagnosis/*microbiology/therapyen_GB
dc.subject.meshEye Infections, Bacterial/diagnosis/*microbiology/therapyen_GB
dc.subject.meshEye Infections, Fungal/diagnosis/*microbiology/therapyen_GB
dc.subject.meshFemaleen_GB
dc.subject.meshHumansen_GB
dc.subject.meshIrelanden_GB
dc.subject.meshMaleen_GB
dc.subject.meshMiddle Ageden_GB
dc.subject.meshOphthalmologic Surgical Proceduresen_GB
dc.subject.meshPatient Admissionen_GB
dc.subject.meshReferral and Consultationen_GB
dc.subject.meshRetrospective Studiesen_GB
dc.subject.meshRisk Factorsen_GB
dc.subject.meshTreatment Outcomeen_GB
dc.subject.meshVisual Acuityen_GB
dc.titleRisk factors, microbiological findings, and clinical outcomes in cases of microbial keratitis admitted to a tertiary referral center in ireland.en_GB
dc.contributor.departmentWaterford Regional Hospital, Waterford, Ireland. aymantalat@gmail.comen_GB
dc.identifier.journalCorneaen_GB
dc.description.provinceMunster-

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