Bacterial keratitis: predisposing factors, clinical and microbiological review of 300 cases
Bacterial keratitis: predisposing factors, clinical and microbiological review of 300 cases
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DOI：
10.1136/bjo.87.7.834
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发表时间：
2003-07-01
影响因子：
4.1
通讯作者：
Laroche, L
中科院分区：
文献类型：
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作者：
Bourcier, T;Thomas, F;Laroche, L
目标：为了确定诱发因素，并确定细菌性角膜炎的临床和微生物学特征，在目前的practice.Methods：回顾性分析的医院记录的患者提出与细菌性角膜炎，并在Quinze Vingts国家眼科中心，巴黎，法国，进行了20个月的时间。细菌性角膜炎定义为化脓性角膜浸润和与角膜刮片上存在细菌相关的上覆上皮缺损和/或经抗生素治疗治愈。结果：300例（291例）疑似细菌性角膜炎患者纳入研究。在90.6%的病例中确定了潜在的诱发因素，通常是多种因素。接触透镜配戴是主要危险因素（50.3%）。分别在15%和21%的病例中发现了创伤或角膜病史。在201只眼（68%）中鉴定出微生物。83%的感染涉及革兰氏阳性菌，17%涉及革兰氏阴性菌，2%为多种微生物。革兰氏阴性菌与严重前房炎症（p=0.004）以及浸润面积较大（p=0.01）相关。99%的溃疡解决与治疗，但只有60%的患者的视力高于入院时的水平，5%有非常差的视觉outcome.Conclusions：接触透镜佩戴是最重要的危险因素。大多数社区获得性细菌性溃疡通过适当的治疗而消退。
Aim: To identify predisposing factors and to define clinical and microbiological characteristics of bacterial keratitis in current practice.Methods: A retrospective analysis of the hospital records of patients presenting with bacterial keratitis and treated at the Quinze-Vingts National Center of Ophthalmology, Paris, France, was performed during a 20 month period. A bacterial keratitis was defined as a suppurative corneal infiltrate and overlying epithelial defect associated with presence of bacteria on corneal scraping and/or that was cured with antibiotic therapy. Risk factors, clinical and microbiological data were collected.Results: 300 cases (291 patients) of presumed bacterial keratitis were included. Potential predisposing factors, usually multiple, were identified in 90.6% of cases. Contact lens wear was the main risk factor (50.3%). Trauma or a history of keratopathy was found in 15% and 21% of cases, respectively. An organism was identified in 201 eyes (68%). 83% of the infections involved Gram positive bacteria, 17% involved Gram negative bacteria, and 2% were polymicrobial. Gram negative bacteria were associated with severe anterior chamber inflammation (p=0.004), as well as greater surface of infiltrates (p=0.01). 99% of ulcers resolved with treatment, but only 60% of patients had visual acuity better than the level at admission, and 5% had very poor visual outcome.Conclusions: Contact lens wear is the most important risk factor. Most community acquired bacterial ulcers resolve with appropriate treatment.