Título

INFECTIOUS KERATITIS IN A TERTIARY HOSPITAL IN BRAZIL: A 21-YEAR REVIEW OF THE EPIDEMIOLOGICAL, LABORATORY, AND CLINICAL DATA

Objetivo

Infectious keratitis is sight-threatening. We conducted a study to define the epidemiological and laboratory profile, as well as the clinical course of infectious keratitis in a tertiary hospital in São Paulo over 21 years.

Método

The medical records of patients treated for infectious keratitis were reviewed. Information about age, sex, predisposing factors, topical treatment, adjuvant therapy, visual acuity, ulcers’ classification, bacterioscopy, culture, and antibiotic sensitivity tests were collected.

Resultado

This study included 163 patients. The median age was 70 (55-78,5) years and 54% were female. Risk factors were identified in 83,4% of the patients. Topical fortified antibiotics were used in 65,6% of the patients. The empirical treatment was curative for 65% of the cases. The median treatment duration was 24 (14-40,5) days. Forty-one patients (25,1%) underwent surgical procedures. The mean variation of visual acuity was -0,25 logMAR, p<0,001. Severe ulcers occurred in 69% of the patients. Culture sensitivity was 42,9%. Bacteria were isolated in 94,5% of the samples and fungi in 5,5%. Staphylococcus aureus was isolated in 20,5%, Streptococcus pneumoniae in 16,4%, and Pseudomonas aeruginosa in 13,6%. All gram-positive bacteria were sensitive to cephalothin, vancomycin, and tested quinolones, except for Staphylococcus intermedius, which was resistant to moxifloxacin. All gram-negative bacteria were sensitive to gentamicin, tobramycin, amikacin, and ciprofloxacin.

Conclusão

Infectious keratitis commonly affects women (54%) with a median age of 70 years and a risk factor (83,4%). Culture revealed 60,3% of gram-positive bacteria. Topical fortified cephalosporin with an aminoglycoside or fourth-generation fluoroquinolone was curative for 65% of the cases.