Ophthalmology in China

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Clinical profiles of bacterial keratitis: a retrospective study on 146 cases

GAO Min1,  ZHANG Yang2,  XIAO Yang1,  WANG Zhi-qun2,  SUN Xu-guang2   

  1.  1. Department of Ophthalmology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100043, China; 2. Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual  Sciences, Beijing Tongren Hospital, Capital Medical University, Beijing 100005, China
  • Received:2016-10-08 Online:2017-05-25 Published:2017-06-02
  • Contact: SUN Xu-guang, Email:sunxg1955@163.com E-mail:sunxg1955@163.com

Abstract:

Objective To elucidate the epidemiological characteristics, clinical signs, laboratory findings, and outcomes in bacterial keratitis. Design Retrospective case series. Participants 146 inpatients (146 eyes) with bacterial keratitis from January 2010 through April 2015 in Beijing Tongren Hospital. Methods The medical records of 146 inpatients (146 eyes) with bacterial keratitis were reviewed retrospectively for clinical features, pathogenic bacterium distribution and drugs sensitivity patterns. Main Outcome Measures Demographic information, clinical findings, treatment, outcomes, laboratory findings and the result of drug-susceptibility test. Results  All 146 cases of bacterial keratitis were single eye-affected. The average age was 46.7 ±18.97 years. Out of which, 82 cases (56.16%) were male. Ocular trauma was the most common cause of bacterial keratitis accounting for 31.5%. Majority of the patients (76 cases, 52.1%) presented after topical antibiotics administration. 19 patients(13.0%) utilized topical steroid and 15 cases (10.3%) used both topical antibiotic and steroid at presentation. 82 cases (56.2%) showed Gram-positive bacterium, and 64 cases (43.8%) showed Gram-negative bacterium. Pseudomonas was identified to be the most common isolate (34.9%), followed by Staphylococcus species (24.0%). As a whole, isolates were most sensitive to gatifloxacin, amikacin and levofloxacin. Most cases(139 cases, 95.2%) resolved with topical administration. Surgical therapies were adopted in 7 cases(4.8%). Conclusion Trauma was the most common risk factor of bacterial keratitis. The most common bacteria isolated were Gram-positives and most of the bacteria isolated were susceptive to gatifloxacin, amikacin and levofloxacin. Therapeutic penetrating keratoplasty (PKP) is the most frequently performed surgery to save the eye and preserve vision in severe infective keratitis.

Key words: bacterial keratitis, antibiotic sensitivity, corneal infection, corneal ulcer;epidemiology, risk factor