Risk Factors and Causative Organisms in Microbial Keratitis

作者：Matthew Green, Andrew Apel, Fiona Jane Stapleton · 发表于：Cornea · 年份：2008 · DOI：10.1097/ico.0b013e318156caf2 · 被引用次数：560 · 研究领域：Ocular Infections and Treatments、Corneal Surgery and Treatments、Ocular Surface and Contact Lens

PURPOSE: To establish the risk factors, causative organisms, levels of antibiotic resistance, patient demographics, clinical presentations, and clinical outcomes of microbial keratitis at a tertiary hospital in Australia. METHODS: Patients who had a corneal scraping for culture over a 5-year period were identified through the local microbiology database, and a retrospective audit of their medical records was carried out. Clinical information was gathered from medical records, and smear, culture, and antibiotic resistance results were from the microbiology database. An index of disease severity was calculated for each patient from scores for the magnitude of the epithelial defect and anterior-chamber reaction and the location of the lesion. Associations between risk factors for keratitis and variables such as patient demographics, causative organism and antibiotic resistance, disease severity, and outcome were analyzed by using analysis of variance and chi tests with appropriate correction for multiple comparisons. RESULTS: Two hundred fifty-three cases of microbial keratitis in 231 patients were included. Sixty percent of patients were men, and there was a bimodal distribution in the age of presentation. Common risk factors for keratitis were contact lens wear (53; 22%), ocular surface disease (45; 18%), ocular trauma (41; 16%), and prior ocular surgery (28; 11%). Gram stains were positive in 33%, with a sensitivity of 53% and specificity of 89%. Cultures of corneal scrapings...