Clinical analysis of Staphylococcal keratitis according to coagulase positivity

Session Details

Session Title: Infections

Session Date/Time: Sunday 23/09/2018 | 16:30-18:00

Paper Time: 16:54

Venue: Room A3, Podium 3

First Author: : C.Cho SOUTH KOREA

Co Author(s): :    S. Lee   N. Choi                 

Abstract Details

Purpose:

To analyze epidemiology, predisposing factor, clinical characteristic, treatment outcome, and antibiotic susceptibility of the patients with Staphylococcal keratitis according to coagulase positivity.

Setting:

Retrospective, case-control study. All of study cases were taken by Department of Ophthalmology, Yeungnam University College of Medicine, South Korea.

Methods:

One hundred thirty-eight microbiologically confirmed Staphylococcal keratitis cases were reviewed retrospectively between January 1998 and December 2017. Epidemiology, predisposing factor, clinical characteristic, treatment outcome, and antibiotic susceptibility were compared between coagulase-negative Staphylococcus (CNS, 90 eyes) and coagulase-positive Staphylococcus (CPS, 48 eyes) group. Antibiotic susceptibility was analyzed for the first decade versus the second decade. Poor clinical outcome was defined as final BCVA worse than 20/200, or decreased VA during treatment, or complications, or requiring surgical intervention. Risk factors for poor clinical outcome were identified through multivariate logistic regression analysis.

Results:

There were no significant differences in sex, age, seasonal distribution, previous ocular surface disease, contact-lens wear, epithelial defect size, and hypopyon between two groups. Corneal trauma was more frequent in CNS than in CPS (44%:27%, p=0.068). Methicillin-resistance was higher in CNS than in CPS (57.8%:35.4%, p=0.020); CNS decreased (61.1%-52.8%, p=0.515) and CPS increased (24.1%-52.6%, p=0.065) over time. Poor clinical outcome was 28.9% in CNS and 40.5% in CPS (p=0.428). In logistic regression, symptom duration>7days (p=0.027, p=0.050) and hypopyon(p=0.033, p=0.006) were significant in both groups, epithelial defect ≥5mm2 (p<0.001) and initial VA<0.1 (p=0.010) were significant only in CNS.

Conclusions:

There were no significant differences in the epidemiological factors and initial clinical characteristics between two groups. In both groups, corneal trauma was the most common cause. Methicillin-resistance was higher in CNS, while CPS showed a tendency of increased resistance in the second decade. There were no significant differences in treatment outcomes between CNS and CPS. Hypopyon and longer symptom duration were associated with treatment prognosis in both two groups.

Financial Disclosure:

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