Titre du document / Document title

Severe microbial keratitis in temperate and tropical Western Australia

Auteur(s) / Author(s)

GEBAUER A. ⁽¹⁾ ; MCGHEE C. N. J. ^{(1 2)} ; CRAWFORD G. J. ^{(1 3)} ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

⁽¹⁾ Department of Ophthalmology, Royal Perth Hospital, Wellington Street, Perth, 6001 Western Australia, AUSTRALIE
⁽²⁾ Corneal Diseases & Excimer Laser Unit, Sunderland Eye Infirmary, Queen Alexandra Road, Sunderland SR2 9HP, ROYAUME-UNI
⁽³⁾ Lions Eye Institute, 2 Verdun Street, Nedlands, Perth, 6009 Western Australia, AUSTRALIE

Résumé / Abstract

To determine the patterns of severe microbial keratitis in Western Australia, all acute admissions over a 2 year period to the Department of Ophthalmology, Royal Perth Hospital were assessed. Fifty-three cases (n = 53) of severe, presumed microbial keratitis were identified. Seventy per cent of these eyes had a visual acuity of 6/60 or less on admission and only 38.8% had 6/12 or better corrected acuity following resolution of the keratitis. The most commonly identified predisposing factors were: prior ocular surgery with or without exposed monofilament sutures (43.4%); contact lens wear (22.6%); lid malposition (17.0%); history of ocular trauma (15.1%); and history of previous herpes simplex keratitis (13.2%). It is notable that 26.4% of the subjects had been applying topical ophthalmic corticosteroids prior to admission. Following corneal scrape or biopsy a positive microbial diagnosis was made in 71% of samples, with Gram-negative and Gram-positive bacterial isolates being equally frequent. Five cases of Acanthamoeba keratitis were identified following corneal biopsy. Where antibiotic sensitivities were available, it was noted that 61.5% of Gram-positive and 46.1% of Gram-negative bacteria were susceptible to chloramphenicol, with 84.6% of Gram-negative bacteria being sensitive to gentamicin. Many of these severe cases of microbial keratitis might have been avoided, or their severity lessened, by earlier identification of predisposing risk factors, more intensive and appropriate antibiotic administration, and improved patient education following ocular surgery.

Revue / Journal Title

Eye   ISSN 0950-222X   CODEN EYEEEC 

Source / Source

1996, vol. 10 (5), pp. 575-580 (40 ref.)

Langue / Language

Anglais

Editeur / Publisher

Nature Publishing Group, Basingstoke, ROYAUME-UNI  (1987) (Revue)

Mots-clés anglais / English Keywords

Keratitis ; Bacteriosis ; Tropical climate ; Risk factor ; Morbidity ; Human ; Western Australia ; Temperate climate ; Infection ; Australia ; Oceania ; Eye disease ; Keratopathy ;

Mots-clés français / French Keywords

Kératite ; Bactériose ; Climat tropical ; Facteur risque ; Morbidité ; Homme ; Australie Occidentale ; Climat tempéré ; Infection ; Australie ; Océanie ; Oeil pathologie ; Kératopathie ;

Mots-clés espagnols / Spanish Keywords

Queratitis ; Bacteriosis ; Clima tropical ; Factor riesgo ; Morbilidad ; Hombre ; Australia occidental ; Clima templado ; Infección ; Australia ; Oceania ; Ojo patología ; Queratopatía ;

Localisation / Location

INIST-CNRS, Cote INIST : 21076, 35400006704630.0120