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Prevalence and spectrum of bacterial co-infection during fungal keratitis
  1. J C Pate1,
  2. D B Jones2,
  3. K R Wilhelmus2
  1. 1Department of Ophthalmology and Visual Science, University of Kentucky College of Medicine, Lexington, KY, USA
  2. 2Sid W Richardson Ocular Microbiology Laboratory, Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, TX, USA
  1. Correspondence to: Kirk R Wilhelmus Sid W Richardson Ocular Microbiology Laboratory, Department of Ophthalmology, Baylor College of Medicine, 6565 Fannin Street, Houston, TX 77030, USA; kirkw{at}


Aims: To estimate the propensity of keratomycosis for parallel or secondary bacterial infection and to explore affinities among fungal and bacterial co-isolates.

Methods: A retrospective review of laboratory records over 24 years yielded 152 episodes of culture positive fungal keratitis. After collating 65 corneal specimens having bacterial co-isolates, polymicrobial co-infection was defined as detection of concordant bacteria on smear and culture or on two or more different media.

Results: 30 (20%) keratomycoses met laboratory criteria for polymicrobial infection. The risk of bacterial co-infection was 3.2 (95% confidence interval, 1.7 to 5.8) times greater with yeast keratitis than with filamentous fungal keratitis.

Conclusions: Bacterial co-infection occasionally complicates fungal keratitis, particularly candidiasis.

  • bacterial co-infection
  • fungal keratitis

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  • Sponsor details/grant support: This work was supported by research grant EY013782 and core grant EY02520 from the National Eye Institute, Bethesda, MD, USA; a senior scientific investigator award from the Research to Prevent Blindness, Inc, New York, NY, USA; and the Sid W Richardson Foundation, Fort Worth, TX, USA.

  • Competing interests: none declared

  • Ethics approval: This study was approved by the institutional review board of Baylor College of Medicine, Houston TX, USA.

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