Factors influencing predilection and outcome in bacterial keratitis.
Complete records from 175 patients with 176 episodes of culture-proven bacterial keratitis treated over a 4-year period at the Massachusetts Eye and Ear Infirmary in Boston were analyzed. Sixty-three percent of the infections involved gram-positive organisms, and 40% involved gram-negative organisms; 15% were polymicrobial. There was a high incidence of infection with Staphylococcus aureus (28%), coagulase-negative staphylococci (14%), diphtheroids (14%), Pseudomonas aeruginosa (14%), and Streptococcus pneumoniae (12%). Gram stain correlation was achieved in 55%. Potential predisposing factors, usually multiple, were identified in 97% of the patients. Fifty percent of the ulcers were associated with such iatrogenic factors as prior topical corticosteroid therapy, penetrating keratoplasty, and contact lens use. Trauma occurred in only 16%. Several statistically significant associations of epidemiologic factors and outcome variables were revealed. Ninety-five percent of the ulcers resolved with therapy, but only 44% of the patients had visual acuity better than the level at admission, and 13% developed major complications.
Gudmundsson
O G
OG
Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston 02114.
Ormerod
L D
LD
Kenyon
K R
KR
Glynn
R J
RJ
Baker
A S
AS
Haaf
J
J
Lubars
S
S
Abelson
M B
MB
Boruchoff
S A
SA
Foster
C S
CS
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001424:Bacterial Infections; D002648:Child; D002675:Child, Preschool; D003315:Cornea / Q000382:microbiology; D005260:Female; D006801:Humans; D007223:Infant; D007634:Keratitis / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D009511:New England; D011379:Prognosis; D012737:Sex Factors; D014792:Visual Acuity