Abstract

Purpose To determine the causative organisms and associated risk factors for infectious keratitis in South Texas.MethodsThis retrospective study was performed at a tertiary teaching hospital system in South Texas. Medical records of all patients who presented with infectious keratitis from 2012 to 2018 were reviewed. Only patients with culture-proven bacterial, fungal, and Acanthamoeba keratitis were included.Results In total, 182 eyes of 181 patients had culture-proven bacterial, fungal, or Acanthamoeba keratitis. The age of patients ranged from 3 to 93 years, with a mean of 48.3 20.8 years. The most common etiologic agent was bacteria, with 173 bacterial cultures (95.1%) recovered, followed by 13 fungal cultures (7.1%), and 3 Acanthamoeba cultures (1.6%). Of the 218 bacterial isolates, coagulase-negative Staphylococcus was the most common (25.7%), followed by Pseudomonas aeruginosa (23.4%), Staphylococcus aureus (11.0%), and Moraxella (7.8%). Fusarium was the most common fungal isolate (46.2%). The most common risk factors for infectious keratitis included contact lens wear (32.4%), underlying corneal disease (17.6%), trauma (14.3%), and ocular surface disease (13.7%).ConclusionsBacteria are the most common cause of infectious keratitis in this patient population, with coagulase-negative Staphylococcus and Pseudomonas as the most common isolates. The prevalence of culture-positive fungal keratitis is significantly lower than that of bacterial keratitis. Contact lens wear is the most common risk factor associated with infectious keratitis in South Texas.

Highlights

  • The screen included multiple International Classification of Diseases (ICD)9 and ICD10 codes to identify patients with keratitis and corneal ulcers. This search yielded 622 patient charts, which were each individually reviewed to confirm a diagnosis of bacterial, fungal, or Acanthamoeba keratitis proven by a positive culture result

  • Of the 621 patients with presumptive infectious keratitis visited between 2012 and 2018, there were a total of 182 eyes of 181 patients with culture-proven bacterial, fungal, or Acanthamoeba keratitis

  • A total of 440 eyes were excluded because cultures were not obtained (n = 279) or were negative (n = 157), or the corneal ulcers were proven by laboratory studies to be secondary to a viral infection (n = 4)

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Summary

Introduction

How to cite this article: Puig M, Weiss M, Salinas R, Johnson DA, Kheirkhah A. Etiology and Risk Factors for Infectious Keratitis in South Texas. Infectious Keratitis in South Texas; Puig et al or viruses. Infection usually begins with epithelial defects in the setting of a weakened ocular defense system and proceeds to stromal invasion, necrosis, and corneal ulceration.[1] Ulcers can lead to visual impairment and may lead to corneal perforation and endophthalmitis. Outcomes of these patients depend on timely diagnosis and treatment with close follow-up

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