Comparison of Culture-Positive and -Negative Microbial Keratitis
Makaleler > Tam Makale · 2022
Yazarlar: Semir YARIMADA, Özlem BARUT SELVER, Melis PALAMAR ONAY, SAİT EĞRİLMEZ, Sabire Şöhret AYDEMİR, Süleyha HİLMİOĞLU POLAT, AYŞE YAĞCI
Turkish Journal of Ophthalmology, Uluslararası, Scopus, 2022, cilt 52, ss 1-5
DOI: 10.4274/tjo.galenos.2021.98046
Özet
Objectives: To evaluate and compare the risk factors, presenting features, and outcomes of patients with culture-positive and culturenegative microbial keratitis (MK) who presented to a tertiary referral center. Materials and Methods:We conducted a retrospective review of the medical records of 314 patients who were diagnosed with MK in our clinic between 2012 and 2019.Results: Among 314 patients, 142 had positive cultures (45.2%).The mean ages of the culture-positive and -negative patients at the time of diagnosis were 51.39±21.31(range, 14-90) years and 56.68±21.34(7-94) years, respectively (p=0.028).The mean best corrected visual acuity (BCVA) of the culture-positive and -negative patients were1.74±1.25 (0-3.1)LogMAR and 1.91±1.23 (0-3.1)LogMAR prior to treatment and increased to 1.21±1.30(0-3.1)LogMAR and 1.27± 1.29 (0-3.1)LogMAR at last visit, respectively.There was no statistically significant difference between culture-positive and -negative patients' BCVA levels at presentation or last visit.Ninetytwo patients (64.7%) were infected with bacteria and 50 patients (35.2%) with fungi.The most common pathogen was Pseudomonas aeruginosa (18.3%), followed by Streptococcus pneumoniae (11.2%) and Fusarium spp.(11.2%).Keratitis foci were either centrally or paracentrally located in 105 eyes (73.9%) of culture-positive patients and 149 eyes (86.6%) of culture-negative patients.Multiple foci were present mostly in culture-positive patients (p=0.001).There was no significant difference between the culture-positive and -negative groups in terms of hypopyon presence (p=0.364).The proportion of contact lens (CL) wearers was 33% (n=47) among culturepositive MK patients and 13.3% (n=23) among culture-negative MK patients, respectively (p<0.001).Culture positivity was found to be significantly higher in keratitis associated with CL use (p=0.0001).Conclusion: Microbiological analysis and culture evaluation are important steps in order to manage proper treatment in microbial keratitis.Prognosis mostly depends on the infectivity of the microbiological agent.