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B. Ovodenko, M. Shah, R.J. Yang, D.C. Ritterband, J.A. Seedor, R.S. Koplin; Propionibacterium Acnes Keratitis . Invest. Ophthalmol. Vis. Sci. 2006;47(13):4753.
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© ARVO (1962-2015); The Authors (2016-present)
To characterize the microbial keratitis associated with cultures positive for Propionibacterium acnes.
A retrospective analysis of the medical records was performed of all patients who had corneal ulcers (CUs) that were positive for P. acnes at the New York Eye and Ear Infirmary from January 1, 2004 through November 15th, 2005. Data collected included ulcer location and size, keratitis risk factors, presence of corneal thinning, type of microbiology media generating growth, and incubation time. CUs were defined as central (less than 2 mm from fixation), peripheral (less than 2 mm from the limbus), or paracentral (area in between). CU size was defined as small (less than 2mm), medium (2 to 6mm), and large (over 6mm).
Of the 961corneal ulcers positive for bacterial growth in that time period 62 (6.5%) were positive for P. acnes. In 21/62(33.9%) of the P. acnes cultures, other organisms were also isolated. Of the 62 CUs, 19(30.6%) were associated with contact lens wear, 10(16.1%) had stromal thinning, and 2(3.2%) progressed to perforation. CUs tended to be small (36, 58%) and widely distributed. The locations were central (17, 27.4 %), paracentral (33, 53.2%), and peripheral (12, 19.6%). 57 of 62(91.9 %) organisms grew in 5% sheep–blood agar in an anaerobic environment (average time of incubation 6.72 days; range: 5–10 days). 51 of 62(82.3 %) organisms grew P. acnes in thioglycolate broth (average time of incubation 6.63 days; range: 4–9 days).
P. acnes are ubiquitous organisms that have been known to cause conjunctivitis, orbital cellulites, and delayed–onset post–cataract endophthalmitis. Although once thought to be a contaminant of cultures, several recent reports have identified P. acnes as a cause of visually significant corneal infection. Our results confirm that P. acnes can cause significant corneal infection with varying presentations and may be more prevalent then previously thought. Cultures for P. acnes should include thioglycolate broth and 5% sheep–blood agar in an anaerobic environment and be incubated for a minimum of 7 days.
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