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Analysis of risk factors and pathogenic bacteria for severe bacterial keratitis

SUN Jing-fen, ZHOU Zheng-shen   

  1. Department of Ophthalmology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
  • Online:2016-06-28 Published:2016-07-25


Objective To investigate epidemiology, microbiology, and clinical manifestations and progression for severe bacterial keratitis and identify its risk factors and pathogenic bacteria. Methods Data of 221 cases (228 eyes) of severe bacterial keratitis treated at the Department of Ophthalmology in Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine between January 2009 and June 2015 were analyzed retrospectively. The bacterial keratitis was confirmed in most patients by bacterial culture for corneal tissues and the secretion from ocular surface. No bacterium was found through bacterial culture in the remainder cases that were highly suspected of bacterial keratitis and responsive to antibiotic treatment. The average follow-up period was (8.55±6.92) months. Results The bacteria detection rate was 75.57% and the major pathogenic bacteria were gram positive cocci (42.54%) and gram negative bacilli (26.32%). The difference in the prognosis of bacterial keratitis caused by these two types of bacteria was not statistically significant (P=0.152). The systemic or ocular risk factors were found in 205 eyes (89.91%), two or more risk factors were identified in 9 eyes (3.94%), and no obvious risk factors were found in 23 eyes (10.09%). Wearing corneal contact lens was the most common risk factor and was accounted for 46.92% (107 eyes, P=0.001). Conclusion The most common risk factor for bacterial keratitis is wearing corneal contact lens. The most common pathogenic bacteria are gram positive cocci and gram negative bacilli. Bacterial keratitis caused by wearing contact lens has the best prognosis.

Key words: severe bacterial keratitis, risk factors, pathogenic bacteria