title: Paediatric infectious keratitis: a case series of 107 children presenting to a tertiary referral centre.
abstract: Corneal ulcers can result in severe visual impairment in children. The recent trends of paediatric microbial ulcerative keratitis in the USA are unknown. The purpose of this study is to report the risk factors, microbiological profile and treatment outcomes of paediatric microbial keratitis in South Florida.
  
  
  
  A university-based tertiary eye care centre retrospective case series between 1992 and 2015. Medical records of 107 paediatric patients (age <18 years) with the diagnosis of microbial ulcerative keratitis were analysed. Patient demographics, culture data, microbial susceptibility, management trends and patient outcomes were collected.
  
  
  
  Mean age of patients was 13±4.6 years (range 0.2-17 years). The most common associated risk factor was contact lens wear (77.6%), followed by ocular trauma (8.4%). Systemic factors were present in 4.7% of cases. Cultures were taken from 89 patients. A total of 74 organisms were isolated from the 52 corneal scrapings with growth, yielding a 58.4% positivity rate. Seventeen microbial species were identified, with a predominance ofPseudomonas aeruginosa(46.2%), followed byStenotrophomonas maltophilia(19.2%) andFusarium(13.5%). Combined fortified antibiotics were the most common treatment (51.4%). Mean follow-up time was 40.6±91.6 weeks (range: 0.3-480 weeks). The mean visual acuity improved from 20/160 to 20/50 (p<0.0001). No therapeutic penetrating keratoplasty was needed.
  
  
  
  In this study, contact lens wear was the most frequent risk factor in infectious keratitis in children.P. aeruginosawas the most common microorganism present in our setting. The majority of the cases responded well to medical management.
authors.affiliation: Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, USA.|Department of Ophthalmology and Visual Sciences, Universidade Federal de São Paulo, Sao Paulo, Brazil.
authors.forename: Julia Dutra
authors.initials: JD
authors.lastname: Rossetto
authors.affiliation: Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, USA.
authors.forename: Kara M
authors.initials: KM
authors.lastname: Cavuoto
authors.affiliation: Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, USA.
authors.forename: Carla J
authors.initials: CJ
authors.lastname: Osigian
authors.affiliation: Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, USA.
authors.forename: Ta Chen Peter
authors.initials: TCP
authors.lastname: Chang
authors.affiliation: Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, USA.
authors.forename: Darlene
authors.identifier: 0000-0002-4756-2030
authors.initials: D
authors.lastname: Miller
authors.affiliation: Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, USA.
authors.forename: Hilda
authors.initials: H
authors.lastname: Capo
authors.affiliation: Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, USA.|Department of Ophthalmology, Tel Aviv Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Oriel
authors.initials: O
authors.lastname: Spierer
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001419:Bacteria / Q000302:isolation & purification*; D002648:Child; D002675:Child, Preschool; D003315:Cornea / Q000382:microbiology*; D019468:Disease Management; D015818:Eye Infections, Bacterial / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D005431:Florida / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007634:Keratitis / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D008297:Male; D008826:Microbial Sensitivity Tests; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D062606:Tertiary Care Centers / Q000706:statistics & numerical data*
chemical_list: D000900:Anti-Bacterial Agents
keywords: Child health (paediatrics); Contact lens; Cornea; Infection; Microbiology