[Diagnostic and therapeutic contribution of microbiological analysis in severe microbial keratitis at Reims University Hospital between 2012 and 2014]

A Comparison of Culture Results and Visual Acuity in Contact Lens Related Microbial Keratitis

PURPOSE

Evaluate the effect of corneal and contact lens-related (CLR) culture results on visual acuity (VA) in patients with microbial keratitis (MK).

METHODS

MK patients with corneal and CLR cultures were identified in the University of Michigan electronic health record from August 2012 to April 2022. Test results were classified as laboratory-positive or laboratory-negative. Linear regression was used to examine trends of VA and associations between changes in VA (differences of VA at 90-day and baseline VA) and corneal and CLR culture results, after adjustment for baseline VA. One-sample t-tests were used to test if the slope estimates were different from zero.

RESULTS

MK patients (n = 50) were on average 49 years old (standard deviation = 20.9), 56% female, and 90% White. Positive corneal and CLR cultures were reported in 60% and 64% of patients, respectively, and 38% reported both. The agreement rate between corneal and CLR culture results was 30% (n = 15/50). LogMAR VA improved over time in patients with positive corneal and CLR cultures (Estimate=-0.19 per 10-day increase, p = 0.002), and in those with negative corneal and positive CLR cultures (Estimate= -0.17 per 10-day increase, p = 0.004). Compared to patients with negative corneal and CLR cultures, there was a trend toward improvement in VA for patients with positive corneal and CLR cultures (Estimate=-0.68, p = 0.068), and those with negative corneal and positive CLR cultures (Estimate= -0.74, p = 0.059), after adjusting for baseline VA.

CONCLUSIONS

Positive CLR cultures are associated with significant improvement in VA over time. These additional cultures can provide guidance on appropriate antimicrobial selection, especially when corneal cultures are negative.

Severe corneal abscess: epidemiology and clinicobacteriological aspect

AIM

To assess epidemiological, clinical and microbiological characteristics of patients presenting with a clinically diagnosed severe corneal abscess at the Farhat Hached Hospital Department of Ophthalmology (Sousse).

METHODS

A retrospective, descriptive and anlalytic study of patients presenting severe corneal abscess was conducted over 5 years, from january 1st of 2013 to septembre 3Oth of 2017. The epidemiological, clinical and microbiological aspects, were analyzed.

RESULTS

one hundred and one of of 100 patients were presented severe corneal abscess. The mean age was 54,1 ans years old. The mean delay for referral was 15,5days. The most frequent Risk factor was chronic keratopathy noted in 59% ofcases. Corneal trauma was noted in (30%) and use of contact lenses in (12%).Visual acuity was less than 1/10 in 72% of the patients. Bacteriological cultures isolated an organism in 39.9 % of cases. Coagulase-negative Staphylococcus (23,3%), Pseudomonas aeruginosa (16,7%), streptococcus (13,3%) were the most frequent species that have been found.

CONCLUSION

A good preliminary analysis of the risk factors, the mode of infection, and the appropriate search for the incriminated germs, allow secondarily an adequate management of the severe corneal abscesses.

Microbiological evaluation of corneal and contact lens cultures in contact lens-associated bacterial keratitis

PURPOSE

To determine the degree of microbiological agreement between corneal scrapings and contact lens cultures in cases of contact lens-associated keratitis.

METHODS

Electronic medical records of all cases of contact lens-associated keratitis at a single institution from April 2006 to May 2019 were reviewed. Cases where both corneal scrapings and contact lens cultures were obtained were included in the study. Group 1 demonstrated agreement between corneal scrapings and contact lens cultures. Group 2 demonstrated growth on both cultures, but disagreement in isolated organism. Group 3 demonstrated negative corneal cultures but growth on contact lens cultures and the diagnostic yield of contact lens microbiological cultures and agreement between corneal and contact lens cultures.

RESULTS

A total of 80 eyes of 72 patients were included in the study. 135 total incidences of microbiological results were included for data analysis. Group 1 contained nine incidences (6.7%), group 2 contained 60 incidences (44.4%) and group 3 contained 66 incidences (49%). In group 3, 50% of the cases were treated based on contact lens culture data. There was no statistically significant difference between all three groups in terms of baseline characteristics, presenting vision, vision at last follow-up, number of antibiotics used or complications from keratitis. Pseudomonas was the most common microorganism isolated, and in 89% of these cases, there was disagreement between corneal and contact lens cultures.

CONCLUSIONS

Although there was a disagreement in the microbiological yield between contact lens and corneal cultures, contact lens cultures were useful in management of patients while achieving similar outcomes.