Cases Of Microbial Keratitis Research Articles

Epidemiology of Microbial Keratitis in Southern California: A Multivariate Analysis

Two hundred twenty-seven cases of microbial keratitis reported in nonreferral county practice were studied. The staphylococci, Pseudomonas aeruginosa and Streptococcus pneumoniae, were the major isolates. A multivariate statistical model was developed to evaluate possible predisposing and outcome determinants. Several racial and age-related relationships were shown. The interaction of numerous local ocular and systemic factors played a fundamental role in causing disease. The authors found significant association between S. pneumoniae and topical steroid use, and direct and indirect linkage of S. aureus with diabetes and trauma, respectively. S. pneumoniae and Moraxella were risk factors for major complications (24% of cases); S. pneumoniae was related to enucleation and late perforation. Corneal exposure and prior topical steroids were associated with prolonged hospital stays. Hypopyon was associated with pneumococcal infection, 60 years of age or older, and trauma. The identification of groups at high-risk for microbial keratitis and problems of preventive management are discussed.

Host, microbial, and pharmacological factors affecting the outcome of suppurative keratitis.

A review of 87 cases of microbial keratitis in South Australia was made to determine the factors which influence the outcome of the disease. The preceding pathology and the extent of ulceration at presentation were found to be significant, while the presence of hypopyon was less important. Infection with Pseudomonas aeruginosa was most likely to result in a poor outcome. Most patients had a history of traumatic injury, herpes simplex keratitis, or a corneal graft. The choice of gentamicin and a cephalosporin as appropriate initial therapy in Australia was supported. The results are discussed with reference to current research objectives.

Contact lens-associated microbial keratitis.

During a 14-year period, 42 cases of microbial keratitis were associated with contact lens (CL) wear. Pseudomonas aeruginosa was isolated in 40% of the cases and Staphylococcus in 31%; Streptococcus pneumoniae, alpha-hemolytic Streptococcus, and Serratia marcescens were the next most commonly isolated pathogens. There was a single fungal corneal ulcer. Bandage CL use was associated with a high prevalence of infection with quasi-commensal organisms and with polymicrobial keratitis, a pattern of disease quite distinct from that induced by other types of CLs. Marked visual loss frequently occurred. There was a disturbing increase in the number of infections associated with extended-wear CLs (worn for either aphakia or myopia) over the last 18 months of the study.