title: Predisposing Factors, Microbial Characteristics, and Clinical Outcome of Microbial Keratitis in a Tertiary Centre in Hong Kong: A 10-Year Experience.
abstract: Purpose. To study the risk factors, microbial profile, antibiotic susceptibility pattern, and outcome for microbial keratitis over the past 10 years in a tertiary center in Hong Kong. Methods. All cases with corneal scraping performed in Queen Mary Hospital, Hong Kong from January 2004 to December 2013 were included. Clinical outcome was defined as poor if the final visual acuity (VA) was abnormal or worse than presenting VA, a major complication occurred, or therapeutic keratoplasty was required. Results. 347 scrapes were performed in the 10-year period growing 130 microorganisms (32.3% culture positive rate). Contact lens use was the commonest risk factor. The commonest isolates were coagulase-negative Staphylococcus and Pseudomonas aeruginosa. Fluoroquinolone susceptibility was tested in 47 Gram-negative bacteria with 93.6% susceptibility (100% for Pseudomonas). 90.7% of cases had good visual outcome. Multivariate logistic regression showed age (p = 0.03), trauma (p = 0.006), and ulcer size >3 mm (p = 0.039) to be independently associated with poor outcome. Conclusion. There was no shifting trend in the isolate distribution or emergence of resistant strains in our study. Contact lens wear was the commonest risk factor, with Pseudomonas being the most frequent isolate in this group. It remained 100% susceptible to fluoroquinolones and 97% cases had good visual outcome.
authors.affiliation: Department of Ophthalmology, LKS Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong.
authors.forename: Alex Lap-Ki
authors.initials: AL
authors.lastname: Ng
authors.affiliation: Department of Microbiology, LKS Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong.
authors.forename: Kelvin Kai-Wang
authors.initials: KK
authors.lastname: To
authors.affiliation: Department of Ophthalmology, LKS Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong.
authors.forename: Chile Chi-Lai
authors.initials: CC
authors.lastname: Choi
authors.affiliation: Department of Ophthalmology, Queen Mary Hospital, Pok Fu Lam, Hong Kong.
authors.forename: Leonard Hsu
authors.initials: LH
authors.lastname: Yuen
authors.affiliation: Department of Ophthalmology, Queen Mary Hospital, Pok Fu Lam, Hong Kong.
authors.forename: Suk-Ming
authors.initials: SM
authors.lastname: Yim
authors.affiliation: Department of Ophthalmology, Queen Mary Hospital, Pok Fu Lam, Hong Kong.
authors.forename: Keith Shun-Kit
authors.initials: KS
authors.lastname: Chan
authors.affiliation: Department of Ophthalmology, LKS Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong.
authors.forename: Jimmy Shiu-Ming
authors.initials: JS
authors.lastname: Lai
authors.affiliation: Department of Ophthalmology, LKS Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong.
authors.forename: Ian Yat-Hin
authors.initials: IY
authors.lastname: Wong