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This is a retrospective single centre study of all patients (with corneal scraping) including their demographic factors, microbiological profiles, and in vitro antibiotic susceptibility of infectious keratitis (IK), studied between 2007 and 2019. The incidence of IK was 34.7/100,000 people / year. 502/1333 (37.7%) corneal scrapes were culture positive. Sixty (4.5%) cases were polymicrobial origin; Gram-positive (G+) bacteria (53.8%), Gram-negative (G-) bacteria (39%), acanthamoeba (4.2%) and fungi (3%). Pseudomonas aeroginosa (23.6%) was the most common organism isolated. Moraxella spp was significantly increased (p<0.001) and Klebsiella spp was decreased (p=0.004) over the study period. The in vitro susceptibilities of G+ and G- bacteria to cephalosporin, fluoroquinolones and aminoglycoside were 100% and 81.3%, 91.9%, and 98.1%, and 95.2% and 98.3% respectively. Increase in Penicillin resistance was observed in G+ (3.5% to 12.7%) and G- (52.6% to 65.4%) during the study period. The authors concluded that future prospective studies are required to include all IK cases without corneal scrapings for the true incidence of IK, better diagnostics yield with confocal microscopy, polymerase chain reaction (PCR), next generation sequencing and close collaboration with microbiological teams for resistance and susceptibility.

 

12-year analysis of incidence, microbiological profile and in vitro antimicrobial susceptibility of infectious keratitis (IK): the Nottingham infectious keratitis study.
DSJ Ting, Ho SH, Cairns J, et al.
BRITISH JOURNAL OF OPHTHALMOLOGY
2021;105:328-33.
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Jonathan Chan

Royal Hallamshire Hospital, Sheffield, UK.

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