title: Clinical presentation and morbidity of contact lens-associated microbial keratitis: a retrospective study.
abstract: OBJECTIVE
  To investigate the clinical presentation, isolated organism, treatment, and morbidity of contact lens-associated microbial keratitis needing hospitalization.
  
  
  METHODS
  This retrospective study included all consecutive patients with contact lens-associated microbial keratitis hospitalized in the Rotterdam Eye Hospital from January 1, 2005, to December 31, 2009. All data regarding epidemiological characteristics, clinical presentation, isolated organism, and treatment were collected from medical records.
  
  
  RESULTS
  There were 109 cases (108 patients) of contact lens-associated microbial keratitis hospitalized during the study period. Mean age was 33.3 ± 15.4 (SD) years. Pseudomonas aeruginosa was the most frequently isolated microorganism (68.8 %), with minor resistance to gentamicin (2.7 %) and ofloxacin (1.3 %). At time of presentation, best corrected visual acuity (BCVA) was very poor, with the largest proportion of patients (65.1 %) seeing worse than 0.05 Snellen. After intensive treatment, the visual outcome improved considerably, with the largest proportion (67.0 %) achieving a BCVA ≥ 0.7 Snellen. Low BCVA at admission was significantly associated with a worse final BCVA. A total of 22 patients (20.2 %) required corneal transplantation (three emergency cases). Larger size of stromal infiltrate was significantly associated with the need for corneal transplantation.
  
  
  CONCLUSIONS
  Microbial keratitis is a serious complication of contact lens wear, with approximately one out of five hospitalized cases requiring corneal transplantation. Ofloxacin, or a combination of gentamicin and cephazolin, still appear to be excellent first-choice therapies in the Netherlands, as little resistance has developed to these antibiotics.
authors.affiliation: The Rotterdam Eye Hospital, Schiedamse Vest 180, 3011 BH, Rotterdam, Netherlands, g.hoddenbach@oogziekenhuis.nl.
authors.forename: Johan G
authors.initials: JG
authors.lastname: Hoddenbach
authors.forename: Sharmila S
authors.initials: SS
authors.lastname: Boekhoorn
authors.forename: Rene
authors.initials: R
authors.lastname: Wubbels
authors.forename: Willem
authors.initials: W
authors.lastname: Vreugdenhil
authors.forename: Jeroen
authors.initials: J
authors.lastname: Van Rooij
authors.forename: Annette J M
authors.initials: AJ
authors.lastname: Geerards
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001419:Bacteria / Q000302:isolation & purification*; D002648:Child; D003261:Contact Lenses / Q000382:microbiology*; D003320:Corneal Ulcer / Q000175:diagnosis* / Q000453:epidemiology* / Q000382:microbiology; D015818:Eye Infections, Bacterial / Q000175:diagnosis* / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D014792:Visual Acuity; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents