Abstract
This study aimed to analyze the frequency, drug susceptibility, and drug resistance of pathogens causing microbial keratitis (a corneal inflammation) in the Clinical Department of Ophthalmology, Medical University of Silesia, Katowice. Despite intensive treatment, severe inflammation causes irreversible blindness in ∼7% of cases and eye loss (evisceration or enucleation of the eyeball) in ∼1% of cases at our hospital. The choice of a targeted drug depends on the culture result and drug resistance of the microorganism. This was a retrospective observation study. Conjunctival swabs and corneal scrapes were collected between January 1, 2013, and December 31, 2019, in the tertiary reference center for keratitis. The collected data included the type of material received, culture result, and antimicrobial susceptibilities. Of the 2482 samples analyzed, 679 were positive and 1803 were negative. Of the total pathogens isolated, 69.9% were Gram-positive bacteria, 20.8% were Gram-negative bacteria, and 7.1% were fungi. A significant increase in the number of Gram-positive methicillin-resistant Staphylococcus aureus and a partial increase in the number of Gram-negative beta-lactams-resistant bacteria were observed. All fungal species were sensitive to amphotericin B, 82.81% were sensitive to voriconazole, and 56.25% were sensitive to fluconazole. Dual drug therapy (levofloxacin and tobramycin) was the first-line treatment. Drug susceptibility testing of the cultured microorganisms is necessary to initiate targeted treatment. Increased drug resistance was observed in this study. In the present study, most bacteria were sensitive to fluoroquinolones. Ciprofloxacin therapy remains the recommended empirical treatment in microbial keratitis. According to our study, voriconazole remains a first-line antifungal drug, when a fungal infection is suspected.
Highlights
Keratitis is a corneal inflammation and has two main types: infectious and noninfectious
2482 samples were analyzed during the study period. e mean age of the patients in the study was 58 ± 21 (SD). 1429 (57.57%) of the cases were men and 1053 (42.42%) were women. 20% of patients wear contact lenses. 236 (9.5%) of patients had in the past corneal graft. e number of tests performed regularly increased during this period
In Belgium, Pseudomonas was found to be the main causative agent of keratitis in a previous study; it is important to note that mainly contact lens wearers were examined in that study [7]
Summary
Keratitis is a corneal inflammation and has two main types: infectious and noninfectious. Infectious keratitis includes bacterial, viral, fungal, and protozoal inflammation, while noninfectious keratitis includes many diseases caused by an abnormal immunological reaction or disturbed physiological processes on the eye surface [1]. Microbial keratitis remains a serious cause of corneal opacification and vision loss worldwide [2]. Infectious keratitis can lead to vision loss. Bacterial keratitis is a potentially devastating ocular infection [3]. Risk factors for bacterial keratitis are wearing contact lens, ocular surface diseases, ocular trauma, reduced immunity, and prior ocular surgery. A significant number of patients with keratitis lose their eyesight, and evisceration or enucleation of the eyeball is necessary in cases with blind painful eyes or in cases in which adjacent tissues are endangered by progressive infection from a blind inflamed eye [2, 4]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
