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M. T. Nguyen, S. X. Deng; Infectious Keratitis: A 5-Year Review of Cases at a Tertiary Referral Center in Southern California. Invest. Ophthalmol. Vis. Sci. 2008;49(13):5525.
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Published data has shown that the distribution and shifting trends of infectious keratitis differ from region to region. The epidemiological characteristics of infectious keratitis on the west coast of the United States have not been reported. The objective of this study is to review the epidemiology, risk factors, microbiologic spectrum, and visual outcomes of microbial keratitis during a five year period at a tertiary eye care center in Southern California.
This is a retrospective review of all culture-positive infectious keratitis encountered at one tertiary referral center Jules Stein Eye Institute - UCLA over a five year period from January 2003 to December 2007. Patient age, gender, risk factors, isolated organisms, and visual outcomes were evaluated for distribution, correlations, and trends.
In total there were 391 positive corneal cultures. Positive cultures were found more frequently in women than men. Patient ages range from 5 months to 99 years, with no statistical significance among the age groups. Fifty-eight different organisms were isolated. Among these culture-positive cases, 222 (79%) patients had only bacterial infections, 38 (13%) patients had only fungal infections, eight (3%) patients had only viral infections, and seven (2%) patients had mixed bacterial with fungal or viral infections. Acanthamoeba was detected in eight cultures. Of the 304 positive bacterial cultures, 231 (60%) were caused by gram positive organisms. The most common bacterial isolate was Staphylococcus species, representing 38% of all positive bacterial cultures, followed by Streptococcus species. The most common fungal pathogen was Candida species, representing 28% of all positive fungal cultures, followed by Fusarium species.
Microbial keratitis affected patients of both genders and all ages. The majority of the positive corneal cultures were bacterial. Our data supports that epidemiological characteristics of infectious keratitis vary geographically. Evaluation of regional causative agents for microbial keratitis has important public health implications and may assist in the management of patients.
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