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S. B. Patel, K. B. Patel, M. A. Saidel; Comparison of Etiology and Antibiotic Susceptibility of Peripheral versus Central Corneal Ulcers Seen at the University of Chicago. Invest. Ophthalmol. Vis. Sci. 2009;50(13):2407.
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To compare the bacterial etiology and susceptibilities of peripheral vs. central corneal uclers. Then analyze if there is predilection of certain organisms to affect certain areas of the cornea as well as differences in virulence of the pathogens causing central or peripheral ulcers.
A retrospective chart review was done for all patients with a corneal ucler between 2002 and 2007 at the University of Chicago. Bacterial culture results and sensitivities were recorded. The ulcers were then subgrouped according to location as central or perpipheral. The results of the cultures, sensitivities and associated findings such as contact lens wear were analyzed and compared.
251 charts were reviewed. 62 patients were identified as having central corneal ulcers. 81 patients were identified with peripheral ulcers. Of the central ulcers 53 were cultured (85%). 34 of these had positive cultures (64%). 29/62 were contact lens wearers (47%). Of the peripheral ulcers 43 were cultured (53%) and 18 were positive (42%). 48/81 were contact lens wearers (59%).The causal bacteria and antibiotic susceptibilities were analyzed and compared.
The 2 most commom bacteria found in both central and peripheral ulcers were Coag negative Staph and Psuedomonas. The susceptibilities were similar, but the Coag neg Staph had less resistence in peripheral ulcers, perhaps indicating less virulence. Interestingly, the Staph aureus in peripheral ulcers had more virulence, but this may be due to a small study number. Further studies should be done to analyze this more and this data should be anaylzed to correlate to visual outcome and treatment measures so that optimal empiric treatment can be initiated for patients with corneal ulcers.
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