학술논문
Epidemiological Characteristics and Microbiological Profile of Infectious Keratitis in the Last Decade at a Tertiary Care Center in Istanbul: A Retrospective Study/Enfeksiyoz Keratitlerin Epidemiyolojik Ozellikleri ve Mikrobiyolojik Profili: Istanbul'da Bir Ucuncu Basamak Merkezde On Yillik Retrospektif Analiz
ORIGINAL ARTICLE
ORIGINAL ARTICLE
Document Type
Report
Author
Source
Hamidiye Medical Journal. December 2023, Vol. 4 Issue 3, p184, 7 p.
Subject
Language
English
Abstract
Introduction Microbial keratitis is a corneal infection caused by bacteria, fungi, parasites, or viruses. Keratit is an important cause of ocular morbidity, which can cause corneal scarring, corneal perforation, and [...]
Background: Regional epidemiological studies are needed for the management of microbial keratitis. The aim of this study was to analyze the epidemiological features, risk factors, causative microorganisms, and antibiotic susceptibility patterns in microbial keratitis in the last decade. Materials and Methods: Medical and laboratory records of patients with microbial keratitis who underwent corneal scrapings between 2013 and 2023 were reviewed. Risk factors, culture results, and antibiotic sensitivity of the microorganisms were evaluated. Results: We obtained a 45.0% culture-positive rate (90/200). The mean age of the patients was 64 [+ or -] 19 years (range: 18-94) (45 female, 45 male). The most common risk factor was corneal transplantation (42.2%). Of all positive cultures, 75 (83.3%) were bacterial and 15 (16.7%) were fungal keratitis. Polymicrobial growth was detected in 13 cultures. In total, 87 bacteria and 16 fungi were isolated. The 103 isolated microorganisms consisted of 46 gram-positive bacteria (44.7%), 41 gram-negative bacteria (39.8%), and 16 fungi. The most frequent microorganisms in bacterial keratitis were Pseudomonas aeruginosa (16.5%), Staphylococcus aureus (13.6%), and Candida species (8.7%) in fungal keratitis. The gentamicin and vancomycin susceptibilities of gram-positive bacteria were 100%. The susceptibility of gram-negative bacteria to various aminoglycosides ranged from 76.5% to 87.0%, which was comparable to that of ceftazidime (81.8%). The susceptibility of all bacterial species to various fluoroquinolones ranged from 77.8% to 100% Conclusion: Bacteria are the most common causative agent of microbial keratitis. The most frequent microorganisms were Pseudomonas aeruginosa and Staphylococcus aureus. According to our results, empirical treatment of bacterial keratitis may be initiated with a combination of vancomycin and cephalosporin or aminoglycoside. Early treatment modification may be considered when a clinical response is not achieved. Keywords: Microbial keratitis, epidemiology, etiology, antibiotic resistance Amac: Mikrobiyal keratitlerin yonetimi icin bolgesel epidemiyolojik calismalara ihtiyac vardir. Calismamizda, klinigimizde son on yilda gorulen mikrobiyal keratit hastalarinin epidemiyolojik ozelliklerini, predispozan risk faktorlerini, kornea kulturlerinden izole edilen mikroorganizmalari ve antibiyotik duyarliligini analiz etmek amaclanmistir. Gerec ve Yontemler: Klinigimizde 2013-2023 yillari arasinda keratit tanisi ile kultur ornegi alinmis hastalarin dosyalari retrospektif olarak tarandi. Hastalar risk faktorlerinin varligi, kultur sonuclari ve antibiyotik duyarliligi acisindan degerlendirildi. Bulgular: Mikrobiyal keratit tanisi ile kultur alinan 200 hastanin, 90'inda kultur pozitifligi elde edildi (%45,0). Hastalarin yas ortalamasi 64 [+ or -] 19 (18-94) olup 45'i kadin 45'i erkekti. En yaygin gorulen risk faktoru korneal transplant (%42,2) idi. Pozitif kulturlerin 75'inden (%83,3) bakteriyel, 15'inden fungal keratit sorumlu idi (%16,7). On uc kulturde polimikrobiyal ureme oldu. Toplamda 87 bakteri ve 16 mantar izole edildi. Izole edilen 103 mikroorganizmanin 46'si gram-pozitif bakteri (%44,7), 41'i gram-negatif bakteri (%39,8) ve 16'si mantar (%15,5) idi. Bakteriyel keratitlerde en yaygin mikroorganizmalar Pseudomonas aeruginosa (%16,5), Staphylococcus aureus (%13,6), iken fungal keratitlerde Candida turleri (%8,7) idi. Gram pozitif bakterilerin Gentamisin ve Vankomisin duyarliligi %100 idi. Gram-negatif bakterilerin cesitli aminoglokozidlere duyarliklari %76,5 ile %87,0 arasinda olup Seftazidim (%81,8) ile karsilastirilabilir duzeydeydi. Tum bakteri turleri icin cesitli florokinolonlara duyarlilik %77,8 ile %100 arasinda degismekteydi. Sonuc: Klinigimizdeki mikrobiyal keratitlerin en yaygin etkeni bakterilerdi. En yaygin mikroorganizmalar Pseudomonas aeruginosa ve Staphylococcus aureus idi. Sonuclarimiza gore bakteriyel keratit ampirik tedavisine vankomisin ile bir sefalosporin veya aminoglikozid kombinasyonu ile baslanabilir. Yakin takip ile kultur sonuclanana kadar ya da kultur negatif olgularda yanit alinamamasi durumunda erken tedavi modifikasyonunu dusunulebilir. Anahtar Kelimeler: Mikrobiyal keratit, epidemiyoloji, etiyoloji, antibiyotik direnci
Background: Regional epidemiological studies are needed for the management of microbial keratitis. The aim of this study was to analyze the epidemiological features, risk factors, causative microorganisms, and antibiotic susceptibility patterns in microbial keratitis in the last decade. Materials and Methods: Medical and laboratory records of patients with microbial keratitis who underwent corneal scrapings between 2013 and 2023 were reviewed. Risk factors, culture results, and antibiotic sensitivity of the microorganisms were evaluated. Results: We obtained a 45.0% culture-positive rate (90/200). The mean age of the patients was 64 [+ or -] 19 years (range: 18-94) (45 female, 45 male). The most common risk factor was corneal transplantation (42.2%). Of all positive cultures, 75 (83.3%) were bacterial and 15 (16.7%) were fungal keratitis. Polymicrobial growth was detected in 13 cultures. In total, 87 bacteria and 16 fungi were isolated. The 103 isolated microorganisms consisted of 46 gram-positive bacteria (44.7%), 41 gram-negative bacteria (39.8%), and 16 fungi. The most frequent microorganisms in bacterial keratitis were Pseudomonas aeruginosa (16.5%), Staphylococcus aureus (13.6%), and Candida species (8.7%) in fungal keratitis. The gentamicin and vancomycin susceptibilities of gram-positive bacteria were 100%. The susceptibility of gram-negative bacteria to various aminoglycosides ranged from 76.5% to 87.0%, which was comparable to that of ceftazidime (81.8%). The susceptibility of all bacterial species to various fluoroquinolones ranged from 77.8% to 100% Conclusion: Bacteria are the most common causative agent of microbial keratitis. The most frequent microorganisms were Pseudomonas aeruginosa and Staphylococcus aureus. According to our results, empirical treatment of bacterial keratitis may be initiated with a combination of vancomycin and cephalosporin or aminoglycoside. Early treatment modification may be considered when a clinical response is not achieved. Keywords: Microbial keratitis, epidemiology, etiology, antibiotic resistance Amac: Mikrobiyal keratitlerin yonetimi icin bolgesel epidemiyolojik calismalara ihtiyac vardir. Calismamizda, klinigimizde son on yilda gorulen mikrobiyal keratit hastalarinin epidemiyolojik ozelliklerini, predispozan risk faktorlerini, kornea kulturlerinden izole edilen mikroorganizmalari ve antibiyotik duyarliligini analiz etmek amaclanmistir. Gerec ve Yontemler: Klinigimizde 2013-2023 yillari arasinda keratit tanisi ile kultur ornegi alinmis hastalarin dosyalari retrospektif olarak tarandi. Hastalar risk faktorlerinin varligi, kultur sonuclari ve antibiyotik duyarliligi acisindan degerlendirildi. Bulgular: Mikrobiyal keratit tanisi ile kultur alinan 200 hastanin, 90'inda kultur pozitifligi elde edildi (%45,0). Hastalarin yas ortalamasi 64 [+ or -] 19 (18-94) olup 45'i kadin 45'i erkekti. En yaygin gorulen risk faktoru korneal transplant (%42,2) idi. Pozitif kulturlerin 75'inden (%83,3) bakteriyel, 15'inden fungal keratit sorumlu idi (%16,7). On uc kulturde polimikrobiyal ureme oldu. Toplamda 87 bakteri ve 16 mantar izole edildi. Izole edilen 103 mikroorganizmanin 46'si gram-pozitif bakteri (%44,7), 41'i gram-negatif bakteri (%39,8) ve 16'si mantar (%15,5) idi. Bakteriyel keratitlerde en yaygin mikroorganizmalar Pseudomonas aeruginosa (%16,5), Staphylococcus aureus (%13,6), iken fungal keratitlerde Candida turleri (%8,7) idi. Gram pozitif bakterilerin Gentamisin ve Vankomisin duyarliligi %100 idi. Gram-negatif bakterilerin cesitli aminoglokozidlere duyarliklari %76,5 ile %87,0 arasinda olup Seftazidim (%81,8) ile karsilastirilabilir duzeydeydi. Tum bakteri turleri icin cesitli florokinolonlara duyarlilik %77,8 ile %100 arasinda degismekteydi. Sonuc: Klinigimizdeki mikrobiyal keratitlerin en yaygin etkeni bakterilerdi. En yaygin mikroorganizmalar Pseudomonas aeruginosa ve Staphylococcus aureus idi. Sonuclarimiza gore bakteriyel keratit ampirik tedavisine vankomisin ile bir sefalosporin veya aminoglikozid kombinasyonu ile baslanabilir. Yakin takip ile kultur sonuclanana kadar ya da kultur negatif olgularda yanit alinamamasi durumunda erken tedavi modifikasyonunu dusunulebilir. Anahtar Kelimeler: Mikrobiyal keratit, epidemiyoloji, etiyoloji, antibiyotik direnci