title: Paediatric infectious keratitis at tertiary referral centres in Vancouver, Canada.
abstract: OBJECTIVE
  To report the clinical and microbiological profiles of paediatric patients with infectious keratitis in Vancouver, Canada.
  
  
  METHODS
  In this observational case series, the microbiology results and medical records of 17 eyes with microbial keratitis in 16 children aged 17 years or younger were retrospectively reviewed. These patients had undergone corneal scraping between May 2006 and April 2011 at BC Children's Hospital or Vancouver General Hospital Eye Care Centre in Vancouver, British Columbia, Canada. Demographic information, clinical features, predisposing factors, results of microbiology studies, antibiotic susceptibilities, treatment course and outcomes were analysed.
  
  
  RESULTS
  The mean age of patients was 11±5.7 years (range 1-17 years) and the male:female ratio was 1.4:1. Major predisposing factors were contact lens wear (6/17; 35%), and pre-existing ocular surface conditions including blepharitis (3/17; 18%) and Stevens-Johnson syndrome (3/17; 18%). Four patients had a previous corneal ulcer. The most commonly isolated microorganisms were Staphylococcus epidermidis and Acanthamoeba. Acanthamoeba was isolated in 67% of contact lens-related corneal ulcers, while the remaining 33% of contact lens-related corneal ulcers were associated with infection with Pseudomonas aeruginosa. Final visual acuity was better than 20/60 in 9 out of 16 patients (56%). Three patients subsequently required surgical management with either penetrating keratoplasty or deep anterior lamellar keratoplasty for treatment of corneal scarring.
  
  
  CONCLUSIONS
  Contact lens wear and pre-existing ocular surface conditions are significant risk factors for the development of infectious keratitis in our paediatric population. Knowledge of regional patterns of infection and susceptibility are essential in ensuring prompt treatment of this potentially sight-threatening condition.
authors.affiliation: Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver General Hospital Vancouver, British Columbia, Canada.
authors.forename: Gelareh S
authors.identifier: http://orcid.org/0000-0001-5785-7441
authors.initials: GS
authors.lastname: Noureddin
authors.affiliation: Department of Ophthalmology, Nozawa Eye Clinic, Setagaya-ku, Tokyo, Japan.
authors.forename: Sachiko
authors.initials: S
authors.lastname: Sasaki
authors.affiliation: Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver General Hospital Vancouver, British Columbia, Canada.
authors.forename: Andrea L
authors.initials: AL
authors.lastname: Butler
authors.affiliation: Microbiology Unit, University of British Columbia, British Columbia Children's Hospital Vancouver, British Columbia, Canada.
authors.forename: Peter
authors.initials: P
authors.lastname: Tilley
authors.affiliation: Division of Microbiology and Infection Control, University of British Columbia Vancouver General Hospital, Vancouver, British Columbia, Canada.
authors.forename: Diane
authors.initials: D
authors.lastname: Roscoe
authors.affiliation: Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver General Hospital Vancouver, British Columbia, Canada.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Lyons
authors.affiliation: Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver General Hospital Vancouver, British Columbia, Canada.
authors.forename: Simon P
authors.initials: SP
authors.lastname: Holland
authors.affiliation: Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver General Hospital Vancouver, British Columbia, Canada.
authors.forename: Sonia N
authors.initials: SN
authors.lastname: Yeung
mesh_terms: D000293:Adolescent; D001955:British Columbia / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003315:Cornea / Q000473:pathology*; D015817:Eye Infections / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007634:Keratitis / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D062606:Tertiary Care Centers / Q000706:statistics & numerical data*; D014505:Urban Population
keywords: Child health (paediatrics); Contact lens; Cornea; Infection; Microbiology