Objective To report the clinical and microbiological profiles of paediatric patients with infectious keratitis in Vancouver, Canada.
Design 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.
- Child health (paediatrics)
- Contact lens
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Contributors GSN and SS: conception/design, analysis/interpretation of data, drafting of work, approval of final version and agreement to be accountable. ALB and SNY: conception/design, analysis/interpretation of data, revision, approval of final version and agreement to be accountable. PT and DR: conception/design, acquisition of data, revision, approval of final version and agreement to be accountable. CJL and SPH: conception/design, acquisition/interpretation of data, revision, approval of final version and agreement to be accountable.
Competing interests None declared.
Patient consent Obtained.
Ethics approval Institutional Research Ethics Board of the University of British Columbia.
Provenance and peer review Not commissioned; externally peer reviewed.
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