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L. Laroche, F. Thomas, C. Chaumeil, V. Borderie, T. Bourcier; Bacterial Keratitis : Predisposing Factors, Clinical and Microbiological Review of 300 Cases . Invest. Ophthalmol. Vis. Sci. 2003;44(13):4764.
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Purpose: The aim of the study was to identify predisposing factors and to define clinical and microbiological characteristics of bacterial keratitis in our current practice. Methods: A retrospective analysis of the hospital records of patients presenting with bacterial keratitis and treated at the Quinze-Vingts National Center of Ophthalmology, Paris, France, was performed during a 20 month period. A bacterial keratitis was defined as a suppurative corneal infiltrate and overlying epithelial defect associated with presence of bacteria on corneal scraping and/or that was cured with antibiotic therapy. Risk factors, clinical and microbiological data were collected. Results: 300 cases (291 patients) of presumed bacterial keratitis were included. Potential predisposing factors, usually multiple, were identified in 90.6% of cases. Contact-lens wear was the main risk factor (50,3%). Trauma or a history of keratopathy was found in 15% and 21% of cases respectively. An organism was identified in 201 eyes (68%). Eighty-three percent of the infections involved gram-positive bacteria, 17% involved gram-negative bacteria, and 2% were polymicrobial. Gram-negative bacteria were associated with severe anterior chamber inflammation (p=0.004), as well as greater surface of infiltrates (p=0.01). Ninety-nine percent of ulcers resolved with therapy, but only 60% of patients had visual acuity better than the level at admission, and 5% had very poor visual outcome. Conclusions: Contact lens wear is the most important risk factor. Most community-acquired bacterial ulcers resolve with appropriate treatment.
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