Polymicrobial keratitis: clinical features, risk factors and outcomes

Session Details

Session Title: Cornea - Medical

Session Date/Time: Monday 07/09/2015 | 08:00-10:30

Paper Time: 09:27

Venue: Room 17

First Author: : M.Fernandes INDIA

Co Author(s): :    D. Vira   D. Dey   D. Tanzin   M. Kumar   D. Sharma        

Abstract Details

Purpose:

To describe the clinical features, risk factors and outcome of microbial keratitis caused by more than one organism.

Setting:

Retrospective study carried out at a Tertiary Eye Care centre, Visakhapatnam, India.

Methods:

Data on microbial keratitis with significant growth of more than one organism in culture was retrieved from the microbiology department. The following data was analyzed : demographics, symptom duration, risk factors, infiltrate characteristics, organisms isolated in culture, antimicrobial susceptibility, complications, surgical interventions, visual acuity and outcome. Complete success was defined as resolution of the infiltrate with scar formation on medical treatment alone. Partial success was defined as resolution following tissue adhesive application. Failure was defined as inadequate response to medical therapy with progressive increase of the infiltrate, corneal melting and or perforation necessitating therapeutic penetrating keratoplasty (PKP) or evisceration.

Results:

There were 34 eyes of 34 patients with polymicrobial keratitis. Almost 80% (27, 79.4%) were males, predominantly working outdoors (21,61.7%). The most common risk factors were trauma (11,32.36%), concomitant steroid usage (8,23.5%) and previous corneal transplant (7,20.59%). A combination of bacteria and fungus was more commonly isolated (23, 67.6%). Out of 67 isolates, filamentous fungi (25, 39.1%) and coagulase negative staphylococci (14, 21.9%) were the most common. Complete success was noted in 11 (39.3%) eyes, partial success in 1(3.6%) eye and failure in 16(57.1%) eyes. All the therapeutic grafts failed. Five (14.7%) eyes were eviscerated due to recalcitrant infection.

Conclusions:

Polymicrobial keratitis with a combination of fungus and bacteria was more common and especially challenging to treat. Medical treatment may be effective however therapeutic PKP provided globe salvage at best.

Financial Interest:

NONE