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Br J Ophthalmol 2003;87:834-838 doi:10.1136/bjo.87.7.834
  • Clinical science
    • Scientific reports

Bacterial keratitis: predisposing factors, clinical and microbiological review of 300 cases

  1. T Bourcier,
  2. F Thomas,
  3. V Borderie,
  4. C Chaumeil,
  5. L Laroche
  1. Quinze-Vingts National Center of Ophthalmology, Paris, France
  1. Correspondence to: Tristan Bourcier, MD, PhD, Service du Professeur Laroche, CHNO des Quinze-Vingts, 28 rue de Charenton 75012 Paris, France; bourcier{at}quinze-vingts.fr
  • Accepted 10 January 2003

Abstract

Aim: To identify predisposing factors and to define clinical and microbiological characteristics of bacterial keratitis in current practice.

Methods: A retrospective analysis of the hospital records of patients presenting with bacterial keratitis and treated at the Quinze-Vingts National Center of Ophthalmology, Paris, France, was performed during a 20 month period. A bacterial keratitis was defined as a suppurative corneal infiltrate and overlying epithelial defect associated with presence of bacteria on corneal scraping and/or that was cured with antibiotic therapy. Risk factors, clinical and microbiological data were collected.

Results: 300 cases (291 patients) of presumed bacterial keratitis were included. Potential predisposing factors, usually multiple, were identified in 90.6% of cases. Contact lens wear was the main risk factor (50.3%). Trauma or a history of keratopathy was found in 15% and 21% of cases, respectively. An organism was identified in 201 eyes (68%). 83% of the infections involved Gram positive bacteria, 17% involved Gram negative bacteria, and 2% were polymicrobial. Gram negative bacteria were associated with severe anterior chamber inflammation (p=0.004), as well as greater surface of infiltrates (p=0.01). 99% of ulcers resolved with treatment, but only 60% of patients had visual acuity better than the level at admission, and 5% had very poor visual outcome.

Conclusions: Contact lens wear is the most important risk factor. Most community acquired bacterial ulcers resolve with appropriate treatment.

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