Microbial keratitis in a tertiary centre in Queensland, Australia (1999-2015).

Clinical relevance: Keratitis is common and studies of blindness throughout the world have found that corneal disease is the second most common cause of blindness.

Background

Microbial keratitis a bacterial, fungal, or protozoan disease of the cornea, characterised by a corneal infiltrate with an overlying epithelial defect and associated anterior chamber reaction.

Methods

Patients were identified through the hospital pathology database and a retrospective chart review of all patients with a positive corneal culture between 1999 and 2015 at Princess Alexandra Hospital was carried out.

Results

There were 895 records from 779 patients included and additional 107 records excluded. The average age of the included patients was 58.9 years (SD 21.0). Males made up 498 (55.6%) of the included patients. Contact lens microbial keratitis (CLMK) was the most common risk factor for MK and was significantly more common in younger patients. CLMK was significantly associated with cultures positive for Pseudomonas aeruginosa (p < 0.001) while MK secondary to ocular surface disease and prior ocular surgery were more commonly associated with gram-positive organisms (p < 0.001). Monotherapy with a fluoroquinolone was the most common treatment for patients with MK. Good outcomes were seen in 57% of patients.

Conclusion

In this patient group, contact lens wear was the most common risk factor for MK. Pseudomonas aeruginosa was the most common isolate.