Paediatric infectious keratitis

A case series of 107 children presenting to a tertiary referral centre

Julia Dutra Rossetto, Kara M Cavuoto, Carla Osigian Probst, Ta Chang, Darlene Miller, Hilda Capo, Oriel Spierer

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background/aims Corneal ulcers can result in severe visual impairment in children. The recent trends of paediatric microbial ulcerative keratitis in the USA are unknown. The purpose of this study is to report the risk factors, microbiological profile and treatment outcomes of paediatric microbial keratitis in South Florida. Methods A university-based tertiary eye care centre retrospective case series between 1992 and 2015. Medical records of 107 paediatric patients (age <18 years) with the diagnosis of microbial ulcerative keratitis were analysed. Patient demographics, culture data, microbial susceptibility, management trends and patient outcomes were collected. Results Mean age of patients was 13±4.6 years (range 0.2-17 years). The most common associated risk factor was contact lens wear (77.6%), followed by ocular trauma (8.4%). Systemic factors were present in 4.7% of cases. Cultures were taken from 89 patients. A total of 74 organisms were isolated from the 52 corneal scrapings with growth, yielding a 58.4% positivity rate. Seventeen microbial species were identified, with a predominance of Pseudomonas aeruginosa (46.2%), followed by Stenotrophomonas maltophilia (19.2%) and Fusarium (13.5%). Combined fortified antibiotics were the most common treatment (51.4%). Mean follow-up time was 40.6±91.6 weeks (range: 0.3-480 weeks). The mean visual acuity improved from 20/160 to 20/50 (p<0.0001). No therapeutic penetrating keratoplasty was needed. Conclusions In this study, contact lens wear was the most frequent risk factor in infectious keratitis in children. P. aeruginosa was the most common microorganism present in our setting. The majority of the cases responded well to medical management.

Original languageEnglish (US)
Pages (from-to)1488-1492
Number of pages5
JournalBritish Journal of Ophthalmology
Volume101
Issue number11
DOIs
StatePublished - Nov 1 2017

Fingerprint

Keratitis
Tertiary Care Centers
Corneal Ulcer
Pediatrics
Contact Lenses
Pseudomonas aeruginosa
Stenotrophomonas maltophilia
Penetrating Keratoplasty
Vision Disorders
Fusarium
Visual Acuity
Medical Records
Demography
Anti-Bacterial Agents
Wounds and Injuries
Therapeutics
Growth

Keywords

  • Child health (paediatrics)
  • Contact lens
  • Cornea
  • Infection
  • Microbiology

ASJC Scopus subject areas

  • Ophthalmology
  • Sensory Systems
  • Cellular and Molecular Neuroscience

Cite this

@article{8ac9306590cf45c08130229b4af894ad,
title = "Paediatric infectious keratitis: A case series of 107 children presenting to a tertiary referral centre",
abstract = "Background/aims Corneal ulcers can result in severe visual impairment in children. The recent trends of paediatric microbial ulcerative keratitis in the USA are unknown. The purpose of this study is to report the risk factors, microbiological profile and treatment outcomes of paediatric microbial keratitis in South Florida. Methods A university-based tertiary eye care centre retrospective case series between 1992 and 2015. Medical records of 107 paediatric patients (age <18 years) with the diagnosis of microbial ulcerative keratitis were analysed. Patient demographics, culture data, microbial susceptibility, management trends and patient outcomes were collected. Results Mean age of patients was 13±4.6 years (range 0.2-17 years). The most common associated risk factor was contact lens wear (77.6{\%}), followed by ocular trauma (8.4{\%}). Systemic factors were present in 4.7{\%} of cases. Cultures were taken from 89 patients. A total of 74 organisms were isolated from the 52 corneal scrapings with growth, yielding a 58.4{\%} positivity rate. Seventeen microbial species were identified, with a predominance of Pseudomonas aeruginosa (46.2{\%}), followed by Stenotrophomonas maltophilia (19.2{\%}) and Fusarium (13.5{\%}). Combined fortified antibiotics were the most common treatment (51.4{\%}). Mean follow-up time was 40.6±91.6 weeks (range: 0.3-480 weeks). The mean visual acuity improved from 20/160 to 20/50 (p<0.0001). No therapeutic penetrating keratoplasty was needed. Conclusions In this study, contact lens wear was the most frequent risk factor in infectious keratitis in children. P. aeruginosa was the most common microorganism present in our setting. The majority of the cases responded well to medical management.",
keywords = "Child health (paediatrics), Contact lens, Cornea, Infection, Microbiology",
author = "Rossetto, {Julia Dutra} and Cavuoto, {Kara M} and {Osigian Probst}, Carla and Ta Chang and Darlene Miller and Hilda Capo and Oriel Spierer",
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doi = "10.1136/bjophthalmol-2016-310119",
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volume = "101",
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T1 - Paediatric infectious keratitis

T2 - A case series of 107 children presenting to a tertiary referral centre

AU - Rossetto, Julia Dutra

AU - Cavuoto, Kara M

AU - Osigian Probst, Carla

AU - Chang, Ta

AU - Miller, Darlene

AU - Capo, Hilda

AU - Spierer, Oriel

PY - 2017/11/1

Y1 - 2017/11/1

N2 - Background/aims Corneal ulcers can result in severe visual impairment in children. The recent trends of paediatric microbial ulcerative keratitis in the USA are unknown. The purpose of this study is to report the risk factors, microbiological profile and treatment outcomes of paediatric microbial keratitis in South Florida. Methods A university-based tertiary eye care centre retrospective case series between 1992 and 2015. Medical records of 107 paediatric patients (age <18 years) with the diagnosis of microbial ulcerative keratitis were analysed. Patient demographics, culture data, microbial susceptibility, management trends and patient outcomes were collected. Results Mean age of patients was 13±4.6 years (range 0.2-17 years). The most common associated risk factor was contact lens wear (77.6%), followed by ocular trauma (8.4%). Systemic factors were present in 4.7% of cases. Cultures were taken from 89 patients. A total of 74 organisms were isolated from the 52 corneal scrapings with growth, yielding a 58.4% positivity rate. Seventeen microbial species were identified, with a predominance of Pseudomonas aeruginosa (46.2%), followed by Stenotrophomonas maltophilia (19.2%) and Fusarium (13.5%). Combined fortified antibiotics were the most common treatment (51.4%). Mean follow-up time was 40.6±91.6 weeks (range: 0.3-480 weeks). The mean visual acuity improved from 20/160 to 20/50 (p<0.0001). No therapeutic penetrating keratoplasty was needed. Conclusions In this study, contact lens wear was the most frequent risk factor in infectious keratitis in children. P. aeruginosa was the most common microorganism present in our setting. The majority of the cases responded well to medical management.

AB - Background/aims Corneal ulcers can result in severe visual impairment in children. The recent trends of paediatric microbial ulcerative keratitis in the USA are unknown. The purpose of this study is to report the risk factors, microbiological profile and treatment outcomes of paediatric microbial keratitis in South Florida. Methods A university-based tertiary eye care centre retrospective case series between 1992 and 2015. Medical records of 107 paediatric patients (age <18 years) with the diagnosis of microbial ulcerative keratitis were analysed. Patient demographics, culture data, microbial susceptibility, management trends and patient outcomes were collected. Results Mean age of patients was 13±4.6 years (range 0.2-17 years). The most common associated risk factor was contact lens wear (77.6%), followed by ocular trauma (8.4%). Systemic factors were present in 4.7% of cases. Cultures were taken from 89 patients. A total of 74 organisms were isolated from the 52 corneal scrapings with growth, yielding a 58.4% positivity rate. Seventeen microbial species were identified, with a predominance of Pseudomonas aeruginosa (46.2%), followed by Stenotrophomonas maltophilia (19.2%) and Fusarium (13.5%). Combined fortified antibiotics were the most common treatment (51.4%). Mean follow-up time was 40.6±91.6 weeks (range: 0.3-480 weeks). The mean visual acuity improved from 20/160 to 20/50 (p<0.0001). No therapeutic penetrating keratoplasty was needed. Conclusions In this study, contact lens wear was the most frequent risk factor in infectious keratitis in children. P. aeruginosa was the most common microorganism present in our setting. The majority of the cases responded well to medical management.

KW - Child health (paediatrics)

KW - Contact lens

KW - Cornea

KW - Infection

KW - Microbiology

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U2 - 10.1136/bjophthalmol-2016-310119

DO - 10.1136/bjophthalmol-2016-310119

M3 - Article

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JO - British Journal of Ophthalmology

JF - British Journal of Ophthalmology

SN - 0007-1161

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