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Queensland Microbial Keratitis Database: 2005–2015
  1. Matthew Green1,2,
  2. Nicole Carnt2,
  3. Andrew Apel3,
  4. Fiona Stapleton2
  1. 1 Ophthalmology department, Gold Coast University Hospital, Southport, Queensland, Australia
  2. 2 School of Optometry and Vision Science, University of New South Wales, Kensington, Queensland, Australia
  3. 3 Ophthalmology department, Princess Alexandra Hospital, Brisbane, Queensland, Australia
  1. Correspondence to Dr Matthew Green, Gold Coast University Hospital, Southport, QLD 4215, Australia; doctormatthewgreen{at}gmail.com

Abstract

Aims To estimate the incidence of culture-positive microbial keratitis in Queensland and analyse trends in the organisms and their sensitivities cultured from corneal scrapes, especially low-incidence organisms.

Methods Retrospective multicentre case series of all positive corneal scrapes in Queensland, Australia between 2005 and 2015. Pathology organisations in Queensland were identified by online and local directory search and agreed to participate. Digital records of scrapes provided patient demographics and culture and susceptibility results. Trends in the incidence, organisms and sensitivities were monitored with linear regression. The yearly incidence of microbial keratitis was estimated from the Queensland population.

Results The included corneal scrapes totalled 3182, while 1006 were excluded. The included scrapes yielded 4111 organisms. Pseudomonas aeruginosa was the most common single isolate (729, 17.7%), although Gram-positive organisms were more common overall (2737, 66.6%). Fungal organisms were cultured in 6% of cases, while Acanthamoeba comprised only 1% of records. Bacterial organisms were sensitive to all recorded antibiotics in 89% of all isolates and none of the reported antibiotics showed a decreasing trend in susceptibility. The incidence of protozoal isolation decreased over time (p=0.055). Cultures positive for yeasts showed a linear increase in incidence (p=0.045) while moulds showed a spike in incidence in 2010–2012 (p=0.0008).

Conclusion The estimated incidence of microbial keratitis was 0.66 cases per 10 000 people, the rate of antibiotic susceptibility is high and stable, the incidence of keratitis secondary to protozoa is likely to be decreasing while the incidence of keratitis culturing yeast is increasing.

  • cornea
  • infection
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Footnotes

  • Contributors All authors have contributed significantly to the writing of this article. MG conceived the project; designed the study; acquired, analysed and interpreted the data; and drafted and revised the paper. NC helped acquire the data and revise the paper. AA helped design the study, interpret the data and revise the paper. FS helped conceive and design the study, interpret the data and revise the paper. All authors gave final paper approval for submission and agree to be accountable for all aspects of the paper.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval This study was approved by the Princess Alexandra Human Research Ethics Committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Data sharing will be considered on application.

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