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Di Zazzo A, Rajan M, Dureja R, Antonini M, Kanduri V, Madduri B, Mohan N, Mohamed A, Fernandes M. Pediatric Microbial Keratitis: Identification of Clinical Biomarkers for Prognosis and Outcome of 218 Cases From 2009 to 2019. Cornea 2022; 41:1103-1109. [PMID: 34935663 DOI: 10.1097/ico.0000000000002957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 11/01/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE The aim of this study was to analyze the risk factors, microbiological profile, and treatment efficacy in pediatric microbial keratitis (MK) and to identify clinical biomarkers prognosticating outcome. METHODS A retrospective analysis was conducted from patients younger than 16 years with MK-excluding viral, marginal, or interstitial keratitis. Data pertaining to predisposing factors, symptom duration, prior treatment, ulcer characteristics, microbiological profile, time to resolution, and final outcome were recorded. Statistical analysis was performed. The mixed-effects linear regression model with random intercept was used to evaluate factors affecting time to resolution. RESULTS Among 218 episodes of 215 pediatric patients with MK, the geometric mean of central [median 3 mm, interquartile range (IQR) 1-4.3 mm] and peripheral ulcers (median 1 mm, IQR 1-2.5 mm) was significantly different ( P < 0.0001). Organisms identified were bacteria (56.9%), fungi (31.5%), and acanthamoebae (2.3%). Of 172 cases (78.8%), which resolved in a median resolution time of 22 days (IQR, 11-44 days), 107 (81.6%) with absent/negative microbiology healed on empirical therapy. On multivariate analysis, peripheral ulcers and geometric mean ulcer size affected time to resolution. Significantly higher percentage of eyes, which worsened or perforated, were on topical steroids compared with those which healed (31.8% vs. 9.2%, P = 0.0061). CONCLUSIONS Good outcome even in culture negative cases suggests empirical therapy may be instituted for nonsevere peripheral pediatric MK; however, the importance of a microbiological workup cannot be underscored enough. Ulcer location and geometric mean size of ulcer may be used as clinical prognostic markers for resolution.
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Affiliation(s)
- Antonio Di Zazzo
- Ophthalmology Complex Operative Unit, University Campus Bio-Medico, Rome, Italy
| | - Mugundhan Rajan
- The Cornea Institute, L V Prasad Eye Institute, GMR Varalakshmi Campus, Visakhapatnam, India
| | - Rohit Dureja
- The Cornea Institute, L V Prasad Eye Institute, GMR Varalakshmi Campus, Visakhapatnam, India
| | - Marco Antonini
- Ophthalmology Complex Operative Unit, University Campus Bio-Medico, Rome, Italy
| | - Vaibhav Kanduri
- The Cornea Institute, L V Prasad Eye Institute, GMR Varalakshmi Campus, Visakhapatnam, India
| | - Bhagyasree Madduri
- Ocular Microbiology Department, L V Prasad Eye Institute, GMR Varalakshmi Campus, Visakhapatnam, India; and
| | - Nitin Mohan
- Ocular Microbiology Department, L V Prasad Eye Institute, GMR Varalakshmi Campus, Visakhapatnam, India; and
| | - Ashik Mohamed
- Ophthalmic Biophysics, L V Prasad Eye Institute, Hyderabad, India
| | - Merle Fernandes
- The Cornea Institute, L V Prasad Eye Institute, GMR Varalakshmi Campus, Visakhapatnam, India
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Pediatric Microbial Keratitis: Experience From Tertiary Referral Centers in New South Wales, Australia. Pediatr Infect Dis J 2020; 39:883-888. [PMID: 32427646 DOI: 10.1097/inf.0000000000002723] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AIMS The purpose of this study was to report the epidemiology, etiology, microbiologic profile and management of pediatric microbial keratitis in a quaternary and 3 tertiary ophthalmic referral centers across Sydney, New South Wales, Australia. METHODS This is a retrospective cohort study of patients ≤ 18 years of age with a clinical diagnosis of microbial keratitis presenting between 1 January 2010 and 31 December 2016 identified from hospital coding and pathology databases. Data were extracted from the medical records. Epidemiology, predisposing factors, referral patterns, microbial profile and treatment outcomes were analyzed. RESULTS Eighty eyes from 80 pediatric patients with microbial keratitis were included in the study (10% had bilateral disease). The mean age was 11 ± 5.3 years (range 0-18 years), and 44 were male (55%). Thirty-six percent of patients had ocular and 13.5% systemic comorbidities. The most common risk factor overall was contact lens wear in 26%, trauma (24%), and external lid and eye disease (20%). Overall, 74 organisms were identified, and of those, the most common isolates were Gram-positive organism. Antimicrobial resistance to common antibiotics was low across all isolates. Visual acuity following treatment was worse than 6/60 for 7 patients (11.3%%), 6/15-6/60 for 15 patients (24.2%) and better than 6/12 for 40 patients (64.5%). Preexisting corneal disease and delay of presentation were associated with worse visual prognosis. Serious complications were noted in 16 (21.3%) of patients. CONCLUSIONS Contact lens wear, trauma and existing ocular disease remain the most significant risk factors in the pediatric population. Preexisting corneal disease and delay in presentation were associated with poor visual acuity. The majority of patients have a good visual outcome although serious complications are not uncommon and may cause lifelong visual disability.
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Di Zazzo A, Antonini M, Fernandes M, Varacalli G, Sgrulletta R, Coassin M. A global perspective of pediatric non-viral keratitis: literature review. Int Ophthalmol 2020; 40:2771-2788. [PMID: 32500305 DOI: 10.1007/s10792-020-01451-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Accepted: 05/23/2020] [Indexed: 02/07/2023]
Abstract
PURPOSE This focused review aims to explore pediatric non-viral keratitis and to compare associated risk factors, etiologies, antibiotic susceptibilities, empiric treatments and outcomes. METHODS The authors performed a literature research for articles, published on PubMed, Google Scholar, Scopus and Embase online library, relevant to pediatric keratitis etiology, risk factors, antibiotic susceptibilities, treatment and outcomes. From the bibliography of selected articles, additional relevant articles were also considered. Of 34 articles identified, 21 were suitable for the purpose of this review. RESULTS Several risk factors are noted in the field of pediatric keratitis. Trauma is the most common in developing countries, while contact lenses wear is seen in developed economies. Previous ocular conditions and systemic diseases also contribute. Associated malnourishment and vitamin A deficit are fraught with a catastrophic prognosis. Among causative organisms, bacteria are more common than fungi and protozoa. Gram-positive organisms are predominant where contact lenses use is infrequent. Pseudomonas aeruginosa is often the leading pathogen in developed countries and is strongly associated with contact lens wear or malnourishment. Fungi are common in the tropics and associated with trauma. Levofloxacin seems the more effective empirical treatment when bacteria are suspected, but there is no agreement on a standard of care. CONCLUSION There are differences in etiologic patterns between developing and developed countries and different regions globally. Risk factors follow the same trend; however, there is no standard regimen being followed for empirical treatment of pediatric infectious keratitis. Associated malnourishment and vitamin A deficiency result in poorer outcomes.
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Affiliation(s)
- Antonio Di Zazzo
- Ophthalmology Complex Operative Unit, University Campus Bio-Medico, Rome, Italy
| | - Marco Antonini
- Ophthalmology Complex Operative Unit, University Campus Bio-Medico, Rome, Italy
| | - Merle Fernandes
- Cornea and Anterior Segment Services, LV Prasad Eye Institute, GMR Varalakshmi Campus, Hanumanthawaka Jn, Visakhapatnam, Andhra Pradesh, 530040, India.
| | - Giuseppe Varacalli
- Ophthalmology Complex Operative Unit, University Campus Bio-Medico, Rome, Italy
| | - Roberto Sgrulletta
- Ophthalmology Complex Operative Unit, University Campus Bio-Medico, Rome, Italy
| | - Marco Coassin
- Ophthalmology Complex Operative Unit, University Campus Bio-Medico, Rome, Italy
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Kaur M, Titiyal JS. Commentary: Pediatric infectious keratitis. Indian J Ophthalmol 2020; 68:440-441. [PMID: 32056997 PMCID: PMC7043167 DOI: 10.4103/ijo.ijo_47_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Affiliation(s)
- Manpreet Kaur
- Cornea, Cataract and Refractive Surgery Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Jeewan S Titiyal
- Cornea, Cataract and Refractive Surgery Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
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Causes and Management Outcomes of Acquired Corneal Opacity in a Preschool Age (0-5 Years) Group: A Hospital-Based Study. Cornea 2019; 38:868-872. [PMID: 31045962 DOI: 10.1097/ico.0000000000001962] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To evaluate the causes and management outcomes of acquired corneal opacity in a preschool age group (0-5 years) at a tertiary care hospital. METHODS Medical records of all cases (0-5 years) with acquired corneal opacity presenting to the cornea clinic of a tertiary eye care hospital from February 2013 to January 2014 were evaluated for age of onset, age at presentation, sex, laterality, cause of opacity, visual acuity, nutritional status, and socioeconomic class of the parents. The etiology of corneal opacity and the type of intervention with outcome at 3 months follow-up were recorded. RESULTS A total of 106 cases were included in the study. The most common cause of corneal scarring was healed infective keratitis (35.8%). Chemical injury, mechanical trauma, and keratomalacia were the other causes, affecting 21.8%, 20.8%, and 16% of the cases, respectively. Optical iridectomy was the most commonly performed procedure (35.8%), followed by lens aspiration with intraocular lens implantation (17.9%) and penetrating keratoplasty (17%). The mean corrected visual acuity (spectacle or contact lens) at the time of presentation and at 3 months after treatment was 2.9 ± 0.3 (perception of light) and 2.2 ± 0.9 (hand motions) logarithm of minimum angle of resolution (logMAR) units, respectively. CONCLUSIONS Chemical injury and keratomalacia are the major causes of acquired corneal opacity in preschool age groups in India and are associated with poor visual prognosis.
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Khauv P, Turner P, Soeng C, Soeng S, Moore CE, Bousfield R, Stoesser N, Emary K, Thanh DP, Baker S, Hang VTT, van Doorn HR, Day NPJ, Parry CM. Ophthalmic infections in children presenting to Angkor Hospital for Children, Siem Reap, Cambodia. BMC Res Notes 2014; 7:784. [PMID: 25369774 PMCID: PMC4228269 DOI: 10.1186/1756-0500-7-784] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Accepted: 10/21/2014] [Indexed: 11/23/2022] Open
Abstract
Background Ophthalmic infections cause significant morbidity in Cambodian children but aetiologic data are scarce. We investigated the causes of acute eye infections in 54 children presenting to the ophthalmology clinic at Angkor Hospital for Children, Siem Reap between March and October 2012. Findings The median age at presentation was 3.6 years (range 6 days – 16.0 years). Forty two patients (77.8%) were classified as having an external eye infection, ten (18.5%) as ophthalmia neonatorum, and two (3.7%) as intra-ocular infection. Organisms were identified in all ophthalmia neonatorum patients and 85.7% of patients with an external eye infection. Pathogens were not detected in either of the intra-ocular infection patients. Most commonly isolated bacteria were Staphylococcus aureus (23 isolates), coagulase-negative staphylococci (13), coliforms (7), Haemophilus influenzae/parainfluenzae (6), Streptococcus pneumoniae (4), and Neisseria gonorrhoeae (2). Chlamydia trachomatis DNA was detected in 60% of swabs taken from ophthalmia neonatorum cases. Conclusions This small study demonstrates the wide range of pathogens associated with common eye infections in Cambodian children. The inclusion of molecular assays improved the spectrum of detectable pathogens, most notably in neonates.
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Affiliation(s)
| | - Paul Turner
- Cambodia-Oxford Medical Research Unit, Angkor Hospital for Children, Siem Reap, Cambodia.
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Sheng XL, Li HP, Liu QX, Rong WN, Du WZ, Ma L, Yan GH, Ma RQ, Zhang JL, Xu HF, Zou WQ, Bi XJ. Prevalence and associated factors of corneal blindness in Ningxia in northwest China. Int J Ophthalmol 2014; 7:557-62. [PMID: 24967208 DOI: 10.3980/j.issn.2222-3959.2014.03.30] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2014] [Accepted: 03/01/2014] [Indexed: 11/02/2022] Open
Abstract
AIM To describe the prevalence and demographic characteristics of corneal blindness in an urban and rural region of Ningxia, located in the northwest part of China. METHODS A stratified, randomized sampling procedure was employed in the study, including urban and rural area of all age group. Visual acuity, anterior segment and ocular fundus were checked. Related factor of corneal disease, including age, gender, education status, ethnic group, location and occupation, were identified according to uniform customized protocol. An eye was defined to be corneal blindness if the visual acuity was <20/400 due to a corneal disease. RESULTS Three thousand individuals (1290 from urban area and 1710 from rural area) participated in the investigation, with a response rate of 80.380%. The prevalence of corneal blindness was 0.023% in both eyes and 0.733% in at least one eye. The blindness in at least one eye with varied causes was present in 106 participants (3.533%) and in bilateral eyes in 34 participants (1.133%). The corneal diseases accounted for 20.754% of blindness in at least one eye and 20.588% of bilateral blindness. The prevalence of corneal disease was higher in older and Han ethnic group, especially those who occupied in agriculture and outdoor work. People with corneal blindness were more likely to be older and lower education. Rural population were more likely to suffer from bilateral corneal blindness than the urban population in ≥59-year group (χ (2)=6.716, P=0.019). Infectious, trauma and immune corneal disease were the three leading causes of corneal disease. Trauma corneal disease was more likely leading to blindness in one eye. However, infectious and immune corneal diseases make more contribution to the bilateral corneal blindness. CONCLUSION Corneal blindness is a significant burden of in Ningxia population, encompassing a variety of corneal infections and trauma; the majority of those were avoidable. Health promotion strategies and good hygienic conditions have to be developed.
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Affiliation(s)
- Xun-Lun Sheng
- Ningxia Eye Hospital, Ningxia People's Hospital, Yinchuan 750011, Ningxia Hui Autonomous Region, China
| | - Hui-Ping Li
- Ningxia Eye Hospital, Ningxia People's Hospital, Yinchuan 750011, Ningxia Hui Autonomous Region, China
| | - Qing-Xia Liu
- Ningxia Eye Hospital, Ningxia People's Hospital, Yinchuan 750011, Ningxia Hui Autonomous Region, China
| | - Wei-Ning Rong
- Ningxia Eye Hospital, Ningxia People's Hospital, Yinchuan 750011, Ningxia Hui Autonomous Region, China
| | - Wen-Zhang Du
- Department of Ophthalmology, Tongxin Hospital, Tongxin 751300, Ningxia Hui Autonomous Region, China
| | - Li Ma
- Department of Ophthalmology, Ningxia Medical University, Yinchuan 750001, Ningxia Hui Autonomous Region, China
| | - Guang-Hui Yan
- Department of Ophthalmology, Ningxia Medical University, Yinchuan 750001, Ningxia Hui Autonomous Region, China
| | - Run-Qing Ma
- Department of Ophthalmology, Ningxia Medical University, Yinchuan 750001, Ningxia Hui Autonomous Region, China
| | - Jian-Ling Zhang
- Ningxia Eye Hospital, Ningxia People's Hospital, Yinchuan 750011, Ningxia Hui Autonomous Region, China
| | - Hui-Fang Xu
- Ningxia Eye Hospital, Ningxia People's Hospital, Yinchuan 750011, Ningxia Hui Autonomous Region, China
| | - Wen-Qing Zou
- Ningxia Eye Hospital, Ningxia People's Hospital, Yinchuan 750011, Ningxia Hui Autonomous Region, China
| | - Xiao-Jun Bi
- Ningxia Eye Hospital, Ningxia People's Hospital, Yinchuan 750011, Ningxia Hui Autonomous Region, China
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Gupta N, Tandon R, Gupta SK, Sreenivas V, Vashist P. Burden of corneal blindness in India. Indian J Community Med 2013; 38:198-206. [PMID: 24302819 PMCID: PMC3831688 DOI: 10.4103/0970-0218.120153] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2012] [Accepted: 03/03/2012] [Indexed: 11/25/2022] Open
Affiliation(s)
- Noopur Gupta
- Department of Community Ophthalmology, Rajendra Prasad Centre for Ophthalmic Sciences, New Delhi, India
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Young AL, Leung KS, Tsim N, Hui M, Jhanji V. Risk factors, microbiological profile, and treatment outcomes of pediatric microbial keratitis in a tertiary care hospital in Hong Kong. Am J Ophthalmol 2013; 156:1040-1044.e2. [PMID: 23972308 DOI: 10.1016/j.ajo.2013.06.019] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2013] [Revised: 06/10/2013] [Accepted: 06/11/2013] [Indexed: 11/25/2022]
Abstract
PURPOSE To report the risk factors and microbiological profile of pediatric microbial keratitis cases in a tertiary care hospital in Hong Kong. DESIGN Retrospective study. METHODS Case records of patients <18 years old with microbial keratitis were reviewed over a period of 10 years, between January 2001 and December 2010. Risk factors, microbiological profile, and treatment outcomes were analyzed. RESULTS Overall, 18 patients (13 female, 5 male) with unilateral microbial keratitis were included. The mean age was 12.4 years (range: 3-17 years). The most commonly associated risk factor was contact lens wear (15, 83.3%). Seven cases (38.8%) were associated with orthokeratology lenses. Two cases (11.1%) were related to intrinsic keratopathy and 1 case (5.5%) was infected secondary to trauma. Microbiological culture was positive in 16 cases (88.8%). Overall, Pseudomonas sp. was the most commonly isolated organism (10/16, 62.5%), followed by coagulase-negative Staphylococcus (5/16, 31.2%) and Corynebacterium sp. (2/16, 12.5%). All cases responded to intensive medical management with topical antibiotics. One case with posttraumatic keratitis required stepped surgeries with initial tectonic penetrating keratoplasty followed by lens aspiration and retinal detachment repair. At the last follow-up, 13 out of 17 eyes (76.5%) had best-corrected visual acuity ≥20/40. CONCLUSIONS Contact lens wear was the most commonly encountered risk factor for the occurrence of microbial keratitis in the pediatric age group in our setting. Orthokeratology remains one of the leading causes of contact lens-related infections. The majority of the cases responded to medical management.).
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Chirinos-Saldaña P, Bautista de Lucio VM, Hernandez-Camarena JC, Navas A, Ramirez-Miranda A, Vizuet-Garcia L, Ortiz-Casas M, Lopez-Espinosa N, Gaona-Juarez C, Bautista-Hernandez LA, Graue-Hernandez EO. Clinical and microbiological profile of infectious keratitis in children. BMC Ophthalmol 2013; 13:54. [PMID: 24131681 PMCID: PMC4015831 DOI: 10.1186/1471-2415-13-54] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2013] [Accepted: 10/06/2013] [Indexed: 11/12/2022] Open
Abstract
Background Infectious keratitis is a sight-threatening condition for children. The purpose of this study was to describe the clinical profile, risk factors and microbiological profile of infectious keratitis in children. Methods Retrospective review of clinical records of patients under 16 years of age with history of microbial keratitis seen at a tertiary referral center. Clinical characteristics, risk factors, visual and surgical outcomes as well as the microbiological profile are analyzed. Results Forty-one eyes of 41 patients. Mean age was 8.7 years. Time between the onset of symptoms and ophthalmological examination was 12.7 days. Predisposing factors were found in 78%; ocular trauma was the most common (25%). Visual acuity equal or worse than 20/200 at admission correlated positively with a poorer visual outcome, p=0.002. Positivity of cultures was 34%. Gram-positive bacteria were isolated in 78.5%; Staphylococcus epidermidis (28.6%) was the most common microorganism. Conclusions Our study emphasizes the importance of a prompt diagnosis and treatment of infectious corneal ulcers in children. Trauma and contact lenses were the main predisposing factors. Gram-positive organisms were isolated in the vast majority of cases and visual outcomes are usually poor.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Enrique O Graue-Hernandez
- Cornea and Refractive Surgery Department, Institute of Ophthalmology "Fundación de Asistencia Privada Conde de Valenciana", Mexico City, Mexico.
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Hong J, Chen J, Sun X, Deng SX, Chen L, Gong L, Cao W, Yu X, Xu J. Paediatric bacterial keratitis cases in Shanghai: microbiological profile, antibiotic susceptibility and visual outcomes. Eye (Lond) 2012; 26:1571-8. [PMID: 23079751 DOI: 10.1038/eye.2012.210] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
PURPOSE The purpose of this study was to review the microbiological profile, in vitro antibiotic susceptibility and visual outcomes of paediatric microbial keratitis in Shanghai, China over the past 6 years. METHODS Medical records of patients aged ≤16 years were reviewed, who were diagnosed as having bacterial keratitis between 1 January 2005 and 31 December 2010. Bacterial culture results and in vitro antibiotic susceptibility were analysed. A logistic regression analysis was conducted to evaluate the relationship between visual impairment and possible risk factors. RESULTS Eighty consecutive cases of paediatric bacterial keratitis cases were included, among which 59 were identified as having positive culture. Staphylococcus epidermidis was the most commonly isolated organism (n=23; 39.0%), followed by Streptococcus pneumoniae (n=11; 18.6%) and Pseudomonas aeruginosa (n=6; 10.2%). Antibiotic sensitivities revealed that tested bacteria had low resistance rates to fluoroquinolones and aminoglycosides (8.3-18.4% and 12.5-24.4%, respectively). Multivariate logistic regression analysis proved that visual impairment was significantly associated with Gram-negative bacterial infection (odds ratio (OR)=7.626; P=0.043) and an increasing number of resistant antibiotics (OR=0.385; P=0.040). CONCLUSIONS S. epidermidis was the most common isolated organism in Shanghai paediatric keratitis. The fluoroquinolones and aminoglycosides remained good choices for treating these patients. Gram-negative bacterial infection and an increasing number of resistant antibiotics were associated with worse visual prognoses in paediatric keratitis.
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Affiliation(s)
- J Hong
- Department of Ophthalmology, Eye, Ear, Nose, and Throat Hospital, School of Shanghai Medicine, Fudan University, 83 Fenyang Road, Shanghai, China
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Al-Otaibi AG. Non-viral microbial keratitis in children. Saudi J Ophthalmol 2012; 26:191-7. [PMID: 23960991 PMCID: PMC3729792 DOI: 10.1016/j.sjopt.2011.10.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2011] [Revised: 09/18/2011] [Accepted: 10/06/2011] [Indexed: 10/16/2022] Open
Abstract
Microbial (non-viral) keratitis is a serious vision-threatening condition. The management of microbial keratitis in children is particularly complicated by the children's inability to cooperate during examinations and the lack of information prior to presentation. Predisposing factors vary according to geographical location and age. Corneal trauma is the leading cause for microbial keratitis in children, followed by systemic and ocular disease. Etiologic agents are most frequently Gram-positive and Gram-negative bacteria commonly found in contact lens-related microbial keratitis. Mycotic keratitis is a major risk factor in tropical weather conditions, particularly when associated with agricultural trauma. Early diagnosis, intensive drug treatment, and timely planned surgical intervention may effectively improve the outcome of pediatric microbial keratitis.
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Affiliation(s)
- Abdullah G. Al-Otaibi
- Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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