Serratia corneal ulcers: a retrospective clinical study.
OBJECTIVE
To study the clinical and microbiological profile of Serratia corneal ulcers at the Cornea Service of the Wills Eye Hospital.


METHODS
This was a retrospective, observational case series. The clinical records of patients with Serratia marcescens corneal ulcers seen at the Cornea Service of the Wills Eye Hospital between January 1, 1998 and December 31, 2002 were reviewed.


RESULTS
Twenty-four cases of Serratia keratitis were identified in 21 patients. Two patients (9.5%) had recurrent keratitis, 1 of which recurred twice. Both had corneal graft edema and were on topical steroids and antiglaucoma drops. The Serratia infection in 15 patients (71%) was associated with an abnormal corneal surface. Twelve of these patients (57%) had the ulcer in a corneal graft, 4 (19%) of which were associated with suture infiltrates. Fifteen patients (71%) were on topical medications-15 used corticosteroids and 13 used antiglaucoma drops. Six patients (29%) were contact lens wearers-1 had a concomitant suture infiltrate associated with a corneal graft, and 5 had otherwise healthy corneas. One isolate lacked in vitro susceptibility to ciprofloxacin and ofloxacin but was susceptible to gentamicin and tobramycin. Nineteen patients had a favorable response to medical therapy. Two patients with poor outcome had large corneal ulcers with severe necrosis and thinning associated with delay in treatment.


CONCLUSIONS
Serratia marcescens keratitis is associated with the presence of an abnormal corneal surface, use of topical medications, and contact lens wear. Prompt medical therapy results in a good clinical response in the majority of cases.
Mah-Sadorra
Jeane Haidee
JH
Cornea Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA 19107, USA.
Najjar
Dany M
DM
Rapuano
Christopher J
CJ
Laibson
Peter R
PR
Cohen
Elisabeth J
EJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003261:Contact Lenses / Q000009:adverse effects; D003315:Cornea / Q000382:microbiology; D003320:Corneal Ulcer / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D015818:Eye Infections, Bacterial / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy; D005260:Female; D006801:Humans; D015994:Incidence; D015948:Keratoplasty, Penetrating; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D016868:Serratia Infections / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy; D012706:Serratia marcescens / Q000302:isolation & purification*; D013530:Surgical Wound Infection / Q000382:microbiology; D016896:Treatment Outcome; D014792:Visual Acuity
D000900:Anti-Bacterial Agents