Purchase this article with an account.
Jessica Weinstein, James Landreneau, Jayne S Weiss; Microbial Keratitis in University Medical Center of New Orleans and Interim LSU Hospital Patient Populations. Invest. Ophthalmol. Vis. Sci. 2017;58(8):4795.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Microbial Keratitis affect approximately 30,000 people each year in the United States and can cause significant vision loss. To better serve our patients with this potentially devastating diagnosis, we investigated how frequently residents follow current culture guidelines from preferred practice patterns and the Will’s Eye Manual. Another goal of this study was to better tailor our therapy by identifying most common organisms and their sensitivities.
This was a retrospective review of all patients 18 years or older seen at Interim LSU Hospital (ILH) and University Medical Center of New Orleans (UMCNO) with a diagnosis of corneal ulcer over a 2.5 year period. Patients with pre-existing collagen vascular disease or significant corneal surface disease, chronic non-healing ulcer or chronic steroid use were excluded. Data was collected from their initial visit including demographics, contact lens wear, slit lamp exam, visual acuity, intraocular pressure, prior antibiotic use, and culture results.
78 patients were identified with a diagnosis of corneal ulcer including 27 females and 51 males. 44 (56%) patients were contact lens wearers. 15 (19%) of patients had hypopyon. 59% of patients had documented central ulcer in the visual axis and 41% of patients had documented peripheral ulcer outside the visual axis. 68% of contact lens wears were cultured, 78% of ulcers ≥2mm were cultured and 78% of ulcers in central visual axis were cultured. If a patient had all 3 of those criteria: ulcer ≥2mm, in the central visual axis and was a contact lens wearer they were cultured 100% of the time unless they had previously been cultured at an outside facility. The most common organisms for contact lens wearers was pseudomonas (25%), all sensitive to ciprofloxacin. The most common organism for non-contact lens wearers was coagulase negative staphylococcus (22%).
If patients had one of the following: contact lens wear, a central ulcer or an ulcer ≥2mm in size they were cultured 68% to 78% of the time. If they had 2 or more of the above criteria they were cultured 73% to 85% of the time and if they had all 3 criteria they were cultured 100% of the time. Based on our study, common practice guidelines for corneal ulcer culture are followed the majority of the time at ILH and UMCNO. The most common organism in our contact lens wearers was pseudomonas.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
This PDF is available to Subscribers Only