First Author: M.Ray SINGAPORE
Co Author(s): D. Lim A. Tan
Purpose:
To identify predisposing factors, clinical and microbiological profile and treatment outcome of polymicrobial keratitis
Setting:
Department of Ophthalmology, National University Hospital, Singapore
Methods:
Eyes with polymicrobial keratitis were identified from microbiological records at a tertiary academic referral centre, from January 2002 to December 2010. Any eyes with infectious keratitis involving two or more pathogens were included. Only culture positive cases were taken into consideration. Various parameters including risk factors, clinical pattern, micrbiological profile and treatment outcome were analyzed from the case records.
Results:
Twenty-one eyes with culture positive polymicrobial keratitis were included in this study. Use of contact lenses was the single most common predisposing factor (13 eyes, 61.9%). However, multiple risk factors were involved in 9 (42.8%) cases. Systemic risk factors were encountered only in 23.8% (n=5) cases. Polybacterial infection was commonest type of polymicrobial infection (n=11, 52.3%), followed by mixed bacterial and fungal infections (n=9, 42.8%). Majority of the eyes were infected with two organisms (n=16, 76.1%) whereas three concurrent organisms were isolated from the rest (n=5). A total of 47 organisms belonging to18 species (Bacteria =13, fungi =5) were isolated from 21 eyes. The pseudomonas aeruginosa and candida were the most frequently isolated bacteria (n = 15) and fungi (n = 5) respectively. In 80.9% (n=17) eyes the infections resolved with medical treatment and surgical interventions were required in the rest. 61.9% (n=13) eyes had visual acuity 6/24 or better.
Conclusions:
Contact lens wear was the most common risk factor in polymicrobial keratitis. Majority of the patients were healthy without any systemic co-morbidity. Most infections resolved with appropriate medical treatment. FINANCIAL DISCLOSURE?: No
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