Microbial characteristics of post-traumatic infective keratitis

BX Lim, VTC Koh, M Ray - European Journal of …, 2018 - journals.sagepub.com
BX Lim, VTC Koh, M Ray
European Journal of Ophthalmology, 2018journals.sagepub.com
Purpose: To determine the demographics, risk factors, clinical and microbiological
characteristics, and treatment outcome of post-traumatic infective keratitis. Methods:
Consecutive patients with post-traumatic 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 …
Purpose
To determine the demographics, risk factors, clinical and microbiological characteristics, and treatment outcome of post-traumatic infective keratitis.
Methods
Consecutive patients with post-traumatic 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 post-traumatic 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.
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