April 2014
Volume 55, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2014
Epidemiology, risk factors, and microbiological profiles of infectious corneal ulcers in Southeastern Louisiana
Author Affiliations & Notes
  • Namita Bhardwaj
    Ophthalmology, Ochsner Clinic Foundation, New Orleans, LA
    Ophthalmology, Louisiana State University, New Orleans, LA
  • Pulin Shah
    Ophthalmology, Ochsner Clinic Foundation, New Orleans, LA
  • Footnotes
    Commercial Relationships Namita Bhardwaj, None; Pulin Shah, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 5457. doi:
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      Namita Bhardwaj, Pulin Shah; Epidemiology, risk factors, and microbiological profiles of infectious corneal ulcers in Southeastern Louisiana. Invest. Ophthalmol. Vis. Sci. 2014;55(13):5457.

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Abstract
 
Purpose
 

To describe the epidemiology, risk factors, and microbiology of patients with infectious corneal ulcers treated at an urban tertiary eye care referral center in New Orleans, Louisiana.

 
Methods
 

We conducted a retrospective chart review of all patients treated for infectious corneal ulcers at Ochsner Medical Center in New Orleans, Louisiana between January 1, 2011-October 31, 2013. These cases were identified by searching for patients historically designated the following ICD-9 codes: corneal ulcer unspecified (370.00), ring corneal ulcer (370.02), central corneal ulcer (370.03), hypopyon ulcer (370.04), mycotic corneal ulcer (370.05), and perforated corneal ulcer (370.06). Primary outcome measures included: patient demographics, predisposing risk factors, microbiology of corneal scrapings, antibiotic choice, and the need for surgery.

 
Results
 

The charts of 247 patients (56.3% female, mean age 45.4 ± 20.1 years) were reviewed. The most common risk factor identified was contact lens wear in 150 (60.7%) patients followed by organic foreign body in 16 (6.5%) patients. 34 (13.8%) patients were pseudophakic and 34 (13.8%) patients had other prior surgery in the affected eye, of which penetrating keratoplasty in 14 (41.2%) was the most common. Medical treatment was initiated in all patients and 31 (12.6%) patients also underwent surgical intervention. Of the surgical procedures performed, 18 (58.1%) patients underwent total penetrating keratoplasty. Of the 143 (57.9%) patients who underwent corneal scraping, 70 (49.0%) demonstrated a positive culture yield. The most common organism isolated was Pseudomonas aeruginosa in 20/70 (28.6%), followed by Staphylococcus aureus 13/70 (18.6%) of which Methicillin-resistant Staphylococcus aureus predominated in 9/13 (69.2%). 16/70 (22.9%) patients had positive fungal cultures where Curvularia was the most common organism isolated in 8/16 (50%). The most commonly prescribed class of antibiotic was fluoroquinolone in 208 (84.2%) patients. 90 (36.4%) patients were treated with fortified antibiotics. Among the 42/70 (60.0%) patients with positive bacterial cultures, 6 (14.3%) were resistant to fluoroquinolones, and 9 (21.4%) were resistant to 3 or more classes of antibiotic.

 
Conclusions
 

This study outlines the features characteristic to this particular patient population to guide further care of patients diagnosed with infectious corneal ulcers.

 
Keywords: 463 clinical (human) or epidemiologic studies: prevalence/incidence • 462 clinical (human) or epidemiologic studies: outcomes/complications • 479 cornea: clinical science  
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