Bacterial Keratitis: A Retrospective Review of 10 Years of Cultures

Detalhes bibliográficos
Autor(a) principal: Serras-Pereira, Rita
Data de Publicação: 2022
Outros Autores: Maleita, Diogo, Vieira, Miguel, Crisóstomo, Sara, Anjos, Rita, Batalha, Carlos, Fernandes, Fernando, Alves, Nuno, Maduro, Vítor, Candelária, Pedro, Feijão, João
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: https://doi.org/10.48560/rspo.25274
Resumo: INTRODUCTION: The purpose of this study is to evaluate demographic features, risk factors, bacterial isolates, antibiotic resistance patterns and therapeutic approach of bacterial keratitis over a period of 10 years in a tertiary referral hospital in Lisbon. M E T HO D S : Retrospective review of all bacterial keratitis diagnosed between 2009 and 2019. RESULTS: A total of 350 patients were diagnosed with bacterial keratitis between 2009 and 2019. Mean age was 54.77 years and 55% of patients were female. Based on first clinical observation, 72.3% of patients were classified as having serious keratitis and 60.86% were managed as in-patients. Contact lenses were the major risk factor identified (30.3%), followed by previous keratoplasty (11.1%) and ocular trauma (10.9%). Cultures were positive for bacteria in 56.86% of patients, with gram-negative bacteria comprising more than half of the isolates (52.26%). Pseudomonas aeruginosa was the most common single isolate (16.3%). Monotherapy with fluoroquinolones was given to 5.7% of patients and 75.4% were treated with fortified drops of ceftazidime and vancomycin. As for outcomes, 41 patients (11.7%) were submitted to a corneal transplant and five patients were eviscerated. CONCLUSION: Bacterial keratitis is a potentially blinding condition that leads to a great number of emergency department visits and inpatient care. Over the last 10 years, Pseudomonas aeruginosa has been the single most common bacterial isolate and contact lens wear the most frequent risk factor for bacterial keratitis in our center. Identifying bacterial isolates and their resistance pattern is of utmost importance for optimal management of patients.
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spelling Bacterial Keratitis: A Retrospective Review of 10 Years of CulturesQueratites Bacterianas: Uma Revisão Retrospectiva de 10 Anos de CulturasArtigos OriginaisINTRODUCTION: The purpose of this study is to evaluate demographic features, risk factors, bacterial isolates, antibiotic resistance patterns and therapeutic approach of bacterial keratitis over a period of 10 years in a tertiary referral hospital in Lisbon. M E T HO D S : Retrospective review of all bacterial keratitis diagnosed between 2009 and 2019. RESULTS: A total of 350 patients were diagnosed with bacterial keratitis between 2009 and 2019. Mean age was 54.77 years and 55% of patients were female. Based on first clinical observation, 72.3% of patients were classified as having serious keratitis and 60.86% were managed as in-patients. Contact lenses were the major risk factor identified (30.3%), followed by previous keratoplasty (11.1%) and ocular trauma (10.9%). Cultures were positive for bacteria in 56.86% of patients, with gram-negative bacteria comprising more than half of the isolates (52.26%). Pseudomonas aeruginosa was the most common single isolate (16.3%). Monotherapy with fluoroquinolones was given to 5.7% of patients and 75.4% were treated with fortified drops of ceftazidime and vancomycin. As for outcomes, 41 patients (11.7%) were submitted to a corneal transplant and five patients were eviscerated. CONCLUSION: Bacterial keratitis is a potentially blinding condition that leads to a great number of emergency department visits and inpatient care. Over the last 10 years, Pseudomonas aeruginosa has been the single most common bacterial isolate and contact lens wear the most frequent risk factor for bacterial keratitis in our center. Identifying bacterial isolates and their resistance pattern is of utmost importance for optimal management of patients.INTRODUÇÃO: O objectivo do estudo foi avaliar as características demográficas, factores de risco, isolados bacterianos, padrões de resistência a antimicrobianos e abordagem terapêutica das queratites bacterianas nos últimos 10 anos num centro de referência terciário em Lisboa. MÉTODOS: Revisão restrospectiva de todas as queratites bacterianas diagnosticadas entre 2009 e 2019. RESULTADOS: Um total de 350 doentes foram diagnosticados com queratite bacteriana entre 2009 e 2019. A idade média foi de 54,77 anos e 55% dos doentes eram do sexo feminino. Com base na primeira avaliação clínica, 72,3% das infecções foram classificadas como graves e 60,86% dos doentes foram tratados em regime de internamento. O uso de lentes de contacto foi o factor de risco major identificado (30,3%), seguido de queratoplastia prévia (11,1%) e trauma ocular (10,9%). As culturas foram positivas para bactérias em 56,86% dos doentes, sendo que os gram-negativos representaram mais de metade dos isolados (52,26%). A Pseudomonas aeruginosa foi o agente isolado mais frequentemente (16,3%). A monoterapia com fluoroquinolonas foi prescrita a 5,7% dos doentes, enquanto 75,4% dos doentes foram tratados com colírios fortificados de ceftazidima e vancomicina. No que diz respeito a outcomes, 41 doentes (11,7%) foram submetidos a transplante de córnea e cinco foram eviscerados. CONCLUSÃO: A queratite bacteriana é uma patologia que leva a um grande número de visitas aos serviços de urgência e necessidade de cuidados em regime de internamento. Nos últimos 10 anos, a Pseudomonas aeruginosa foi o agente isolado com maior frequência e o uso de lentes de contacto o factor de risco mais importante. A identificação dos isolados bacterianos e dos seus padrões de resistência é fundamental para poder optimizar os cuidados prestados aos doentes.Ajnet2022-06-30T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlehttps://doi.org/10.48560/rspo.25274eng1646-69501646-6950Serras-Pereira, RitaMaleita, DiogoVieira, MiguelCrisóstomo, SaraAnjos, RitaBatalha, CarlosFernandes, FernandoAlves, NunoMaduro, VítorCandelária, PedroFeijão, Joãoinfo:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2022-10-13T20:30:15Zoai:ojs.revistas.rcaap.pt:article/25274Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:01:47.161061Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Bacterial Keratitis: A Retrospective Review of 10 Years of Cultures
Queratites Bacterianas: Uma Revisão Retrospectiva de 10 Anos de Culturas
title Bacterial Keratitis: A Retrospective Review of 10 Years of Cultures
spellingShingle Bacterial Keratitis: A Retrospective Review of 10 Years of Cultures
Serras-Pereira, Rita
Artigos Originais
title_short Bacterial Keratitis: A Retrospective Review of 10 Years of Cultures
title_full Bacterial Keratitis: A Retrospective Review of 10 Years of Cultures
title_fullStr Bacterial Keratitis: A Retrospective Review of 10 Years of Cultures
title_full_unstemmed Bacterial Keratitis: A Retrospective Review of 10 Years of Cultures
title_sort Bacterial Keratitis: A Retrospective Review of 10 Years of Cultures
author Serras-Pereira, Rita
author_facet Serras-Pereira, Rita
Maleita, Diogo
Vieira, Miguel
Crisóstomo, Sara
Anjos, Rita
Batalha, Carlos
Fernandes, Fernando
Alves, Nuno
Maduro, Vítor
Candelária, Pedro
Feijão, João
author_role author
author2 Maleita, Diogo
Vieira, Miguel
Crisóstomo, Sara
Anjos, Rita
Batalha, Carlos
Fernandes, Fernando
Alves, Nuno
Maduro, Vítor
Candelária, Pedro
Feijão, João
author2_role author
author
author
author
author
author
author
author
author
author
dc.contributor.author.fl_str_mv Serras-Pereira, Rita
Maleita, Diogo
Vieira, Miguel
Crisóstomo, Sara
Anjos, Rita
Batalha, Carlos
Fernandes, Fernando
Alves, Nuno
Maduro, Vítor
Candelária, Pedro
Feijão, João
dc.subject.por.fl_str_mv Artigos Originais
topic Artigos Originais
description INTRODUCTION: The purpose of this study is to evaluate demographic features, risk factors, bacterial isolates, antibiotic resistance patterns and therapeutic approach of bacterial keratitis over a period of 10 years in a tertiary referral hospital in Lisbon. M E T HO D S : Retrospective review of all bacterial keratitis diagnosed between 2009 and 2019. RESULTS: A total of 350 patients were diagnosed with bacterial keratitis between 2009 and 2019. Mean age was 54.77 years and 55% of patients were female. Based on first clinical observation, 72.3% of patients were classified as having serious keratitis and 60.86% were managed as in-patients. Contact lenses were the major risk factor identified (30.3%), followed by previous keratoplasty (11.1%) and ocular trauma (10.9%). Cultures were positive for bacteria in 56.86% of patients, with gram-negative bacteria comprising more than half of the isolates (52.26%). Pseudomonas aeruginosa was the most common single isolate (16.3%). Monotherapy with fluoroquinolones was given to 5.7% of patients and 75.4% were treated with fortified drops of ceftazidime and vancomycin. As for outcomes, 41 patients (11.7%) were submitted to a corneal transplant and five patients were eviscerated. CONCLUSION: Bacterial keratitis is a potentially blinding condition that leads to a great number of emergency department visits and inpatient care. Over the last 10 years, Pseudomonas aeruginosa has been the single most common bacterial isolate and contact lens wear the most frequent risk factor for bacterial keratitis in our center. Identifying bacterial isolates and their resistance pattern is of utmost importance for optimal management of patients.
publishDate 2022
dc.date.none.fl_str_mv 2022-06-30T00:00:00Z
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