Clinical and microbiological profile of infectious keratitis in children

Springer Science and Business Media LLC - Tập 13 - Trang 1-6 - 2013
Patricia Chirinos-Saldaña1, Victor Manuel Bautista de Lucio2, Julio Cesar Hernandez-Camarena1, Alejandro Navas1, Arturo Ramirez-Miranda1, Lizet Vizuet-Garcia2, Mariana Ortiz-Casas2, Nadia Lopez-Espinosa2, Carolina Gaona-Juarez2, Luis Antonio Bautista-Hernandez2, Enrique O Graue-Hernandez1
1Cornea and Refractive Surgery Department, Institute of Ophthalmology “Fundación de Asistencia Privada Conde de Valenciana”, Mexico City, Mexico
2Microbiology and Ocular Proteomics, Research Unit, Institute of Ophthalmology “Fundación de Asistencia Privada Conde de Valenciana”, Mexico City, Mexico

Tóm tắt

Infectious keratitis is a sight-threatening condition for children. The purpose of this study was to describe the clinical profile, risk factors and microbiological profile of infectious keratitis in children. Retrospective review of clinical records of patients under 16 years of age with history of microbial keratitis seen at a tertiary referral center. Clinical characteristics, risk factors, visual and surgical outcomes as well as the microbiological profile are analyzed. Forty-one eyes of 41 patients. Mean age was 8.7 years. Time between the onset of symptoms and ophthalmological examination was 12.7 days. Predisposing factors were found in 78%; ocular trauma was the most common (25%). Visual acuity equal or worse than 20/200 at admission correlated positively with a poorer visual outcome, p=0.002. Positivity of cultures was 34%. Gram-positive bacteria were isolated in 78.5%; Staphylococcus epidermidis (28.6%) was the most common microorganism. Our study emphasizes the importance of a prompt diagnosis and treatment of infectious corneal ulcers in children. Trauma and contact lenses were the main predisposing factors. Gram-positive organisms were isolated in the vast majority of cases and visual outcomes are usually poor.

Tài liệu tham khảo

Whitcher JP, Srinivasan M: Cornel ulceration in the developing world a silent epidemic. Br J Ophthalmol. 1997, 8: 622-631. Parmar P, Salman A, Kalavathy CM, Kaliamurthy J, Thomas PA, Jesudasan CA: Microbial keratitis at extremes of age. Cornea. 2006, 25 (2): 153-158. 10.1097/01.ico.0000167881.78513.d9. Underwood BA: Update: xerophthalmia, keratomalacia, and child mortality including measles. World Blindness and Its Prevention. Volume 4. Edited by: Kupfur C, Gillen T. 1990, Oxford: Oxford University Press, 171-175. Maurin JF, Renard JP, Ahmedou O, Bidaux F, Dordain Y, Pariselle J, Froussart F, Dot C, Rigal-Sastourne JC: [Corneal blindness in tropical areas]. Med Trop (Mars). 1995, 55 (4 Pt 2): 445-449. Ormerod LD, Murphree AL, Gomez DS, Schanzlin DJ, Smith RE: Microbial keratitis in children. Ophthalmology. 1986, 93 (4): 449-455. Young AL, Leung AT, Cheng LL, Law RW, Wong AK, Lam DS: Orthokeratology lens-related corneal ulcers in children: a case series. Ophthalmology. 2004, 111 (3): 590-595. 10.1016/j.ophtha.2003.06.003. Satpathy G, Vishalakshi P: Ulcerative keratitis: Microbial profile and sensitivity pattern: A five year study. Ann Ophthalmol. 1995, 27 (5): 301-306. Dandona L, Dandona R: Revision of visual impairment definitions in the International Statistical Classification of Diseases. BMC Med. 2006, 16: 4-7. Clinical and Laboratory Standards Institute: Performance standards for antimicrobial susceptibility testing: Seventeenth informational supplement. CLSI document M100-S17. 2007, 940 West Valley Road, Suite 1400, Wayne, Pennsylvania: Clinical and Laboratory Standards Institute, 19087-1898. 1-56238-625-5 Carlton J, Karnon J, Czoski-Murray C, Smith KJ, Marr J: The clinical effectiveness and cost-effectiveness of screening programmes for amblyopia and strabismus in children up to the age of 4–5 years: a systematic review and economic evaluation. Health Technol Asess. 2008, 12 (25): 194-iii, xi Cruz OA, Sabir SM, Capo H, Alfonso EC: Microbial keratitis in childhood. Ophthalmology. 1993, 100: 192-196. Al Otaibi AG, Allam K, Damri AJ, Shamri AA, Kalantan H, Mousa A: Childhood microbial keratitis. Oman J Ophthalmol. 2012, 5 (1): 28-31. 10.4103/0974-620X.94763. Song X, Xu L, Sun S, Zhao J, Xie L: Pediatric microbial keratitis: a tertiary hospital study. Eur J Ophthalmol. 2012, 22 (2): 136-141. 10.5301/EJO.2011.8338. Dart JK, Radford CF, Minassian D, Verma S, Stapleton F: Risk factors for microbial keratitis with contemporary contact lenses: a case–control study. Ophthalmology. 2008, 115 (10): 1647-1654. 10.1016/j.ophtha.2008.05.003. Stapleton F, Keay L, Edwards K, Naduvilath T, Dart JK, Brian G, Holden BA: The incidence of contact lens-related microbial keratitis in Australia. Ophthalmology. 2008, 115 (10): 1655-1662. 10.1016/j.ophtha.2008.04.002. Behlau I, Gilmore MS: Microbial biofilms in ophthalmology and infectious disease. Arch Ophthalmol. 2008, 126 (11): 1572-1581. 10.1001/archopht.126.11.1572. Shovlin JP, Argüeso P, Carnt N, Chalmers RL, Efron N, Fleiszig SM, Nichols JJ, Polse KA, Stapleton F, Wiley L, Willcox M, Bright FV, Efron N, Jones LW, Keir N, Peterson RC, Stapleton F: 3. Ocular surface health with contact lens wear. Cont Lens Anterior Eye. 2013, 36 (1): 14-21. Watt K, Swarbrick HA: Microbial keratitis in overnight orthokeratology: review of the first 50 cases. Eye Contact Lens. 2005, 31 (5): 201-208. 10.1097/01.icl.0000179705.23313.7e. Wong VWY, Lai TYY, Chi SCC, Lam DSC: Pediatric ocular surface infections: a 5-year review of demographics, clinical features, risk factors, microbiological results, and treatment. Cornea. 2011, 30: 995-1002. 10.1097/ICO.0b013e31820770f4. Emery PW, Sanderson P: The effects of dietary restriction on protein synthesis and wound healing after surgery in the rat. Clin Sci. 1995, 89 (4): 383-388. Kunimoto DY, Sharma S, Reddy MK, Gopinathan U, Jyothi J, Miller D, Rao GN: Microbial keratitis in children. Ophthalmology. 1998, 105 (2): 252-257. 10.1016/S0161-6420(98)92899-8. Vajpayee RB, Ray M, Panda A, Sharma N, Taylor HR, Murthy GV, Satpathy G, Pandey RM: Risk factors for pediatric presumed microbial keratitis: a case–control study. Cornea. 1999, 18 (5): 565-569. 10.1097/00003226-199909000-00009. Jhanji V, Naithani P, Lamoureux E, Agarwal T, Sharma N, Vajpayee RB: Immunization and nutritional profile of cases with atraumatic microbial keratitis in preschool age group. Am J Ophthalmol. 2011, 151 (6): 1035-1040. 10.1016/j.ajo.2011.01.006. Singh G, Palanisamy M, Madhavan B, Rajaraman R, Narendran K, Kour A, Venkatapathy N: Multivariate analysis of childhood microbial keratitis in South India. Ann Acad Med Singapore. 2006, 35 (3): 185-189. Pinna A, Zanetti S, Sotgiu M, Sechi LA, Fadda G, Carta F: Identification and antibiotic susceptibility of coagulase negative staphylococci isolated in corneal/external infections. Br J Ophthalmol. 1999, 83 (7): 771-773. 10.1136/bjo.83.7.771. Kattan HM, Flynn HW, Pflugfelder SC, Robertson C, Forster RK: Nosocomial endophthalmitis survey. Current incidence of infection after intraocular surgery. Ophthalmology. 1991, 98 (2): 227-238. Speaker MG, Milch FA, Shah MK, Eisner W, Kreiswirth BN: Role of external bacterial flora in the pathogenesis of acute postoperative endophthalmitis. Ophthalmology. 1991, 98 (5): 639-649. discussion 650 Asbell PA, Colby KA, Deng S, McDonnell P, Meisler DM, Raizman MB, Sheppard JD, Sahm DF: Ocular TRUST: nationwide antimicrobial susceptibility patterns in ocular isolates. Am J Ophthalmol. 2008, 145 (6): 951-958. 10.1016/j.ajo.2008.01.025. Chalita MR, Hofling-Lima AL, Paranhos A, Schor P, Belfort R: Shifting trends in in vitro antibiotic susceptibilities for common ocular isolates during a period of 15 years. Am J Ophthalmol. 2004, 137 (1): 43-51. 10.1016/S0002-9394(03)00905-X. Graves A, Henry M, O'Brien TP, Hwang DG, Van Buskirk A, Trousdale MD: In vitro susceptibilities of bacterial ocular isolates to fluoroquinolones. Cornea. 2001, 20 (3): 301-305. 10.1097/00003226-200104000-00012. Guzmán Lista MDC, Lozada Oca RA: Detección de Staphylococcus aureus meticilino-resistentes aislados de pacientes con infecciones nosocomiales y adquiridas en la comunidad. Rev Soc Ven Microbiol. 2007, 27: 349-363. The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2415/13/54/prepub