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Bacterial keratitis: predisposing factors, clinical and microbiological review of 300 cases Bourcier T; Thomas F; Borderie V; Chaumeil C; Laroche LBr J Ophthalmol 2003[Jul]; 87 (7): 834-8AIM: 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.|Adolescent[MESH]|Adult[MESH]|Aged[MESH]|Aged, 80 and over[MESH]|Anti-Bacterial Agents/therapeutic use[MESH]|Bacterial Infections/drug therapy/*microbiology[MESH]|Child[MESH]|Child, Preschool[MESH]|Contact Lenses/adverse effects[MESH]|Cornea/microbiology[MESH]|Corneal Diseases/microbiology[MESH]|Eye Injuries/microbiology[MESH]|Female[MESH]|Humans[MESH]|Infant[MESH]|Keratitis/drug therapy/*microbiology[MESH]|Male[MESH]|Middle Aged[MESH]|Pseudomonas Infections/drug therapy/microbiology[MESH]|Retrospective Studies[MESH]|Risk Factors[MESH]|Staphylococcal Infections/drug therapy/microbiology[MESH]|Suppuration[MESH]|Treatment Outcome[MESH] |