title: Immunization and nutritional profile of cases with atraumatic microbial keratitis in preschool age group.
abstract: OBJECTIVE
  To evaluate the role of protein energy malnutrition and immunization profile in cases of atraumatic microbial keratitis in preschool children.
  
  
  METHODS
  Retrospective case analysis.
  
  
  METHODS
  Case records of all children 5 years of age and younger with atraumatic microbial keratitis treated at the Dr Rajendra Prasad Centre for Ophthalmic Sciences, New Delhi, India, between January and December 2006 were reviewed retrospectively. Main parameters evaluated were age, degree of protein-energy malnutrition, immunization profile, microbiologic profile, and final outcome.
  
  
  RESULTS
  Fifty-four consecutive children were enrolled during the study period. The mean age was 33.69 ± 21.91 months (range, 3 to 60 months). Mean weight on presentation was 10.57 ± 3.87 kg (range, 4 to 17 kg), with an average protein-energy malnutrition grade of 1.77 ± 0.74. The immunization for age was complete in 43 (80%) children. Severe protein-energy malnutrition was associated with the occurrence of bilateral keratitis (P < .001) and incomplete immunization (P < .001). Positive bacterial culture results were obtained in 44 (82%) cases, with Staphylococcus species being the most prevalent isolate (33/44; 75%). Cases requiring emergency corneal transplantation (24%) were associated with severe protein-energy malnutrition (P < .00) and bilaterality (P < .00). In multivariate analyses, cases without severe protein-energy malnutrition were 36% less likely to undergo any kind of surgical intervention (odds ratio, 0.64; 95% confidence interval, 0.04 to 0.91).
  
  
  CONCLUSIONS
  Our study highlights the association of protein-energy malnutrition and immunization profile with the occurrence of atraumatic microbial keratitis in preschool children. Most of these cases required corneal transplantation surgery to preserve the ocular integrity and to restore vision.
authors.affiliation: Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong.
authors.forename: Vishal
authors.initials: V
authors.lastname: Jhanji
authors.forename: Prashant
authors.initials: P
authors.lastname: Naithani
authors.forename: Ecosse
authors.initials: E
authors.lastname: Lamoureux
authors.forename: Tushar
authors.initials: T
authors.lastname: Agarwal
authors.forename: Namrata
authors.initials: N
authors.lastname: Sharma
authors.forename: Rasik B
authors.initials: RB
authors.lastname: Vajpayee
mesh_terms: D001835:Body Weight; D002664:Child Nutritional Physiological Phenomena; D002675:Child, Preschool; D016039:Corneal Transplantation; D003320:Corneal Ulcer / Q000209:etiology* / Q000601:surgery; D004756:Enterobacteriaceae Infections / Q000209:etiology / Q000601:surgery; D015818:Eye Infections, Bacterial / Q000209:etiology* / Q000601:surgery; D005260:Female; D006801:Humans; D007114:Immunization; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D008297:Male; D011502:Protein-Energy Malnutrition / Q000150:complications*; D011552:Pseudomonas Infections / Q000209:etiology / Q000601:surgery; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000209:etiology / Q000601:surgery