[Serious bacterial keratitis: a retrospective clinical and microbiological study].

AIM

To define clinical and microbiological characteristics of patients with bacterial keratitis hospitalized in the Bordeaux University Hospital Department of Ophthalmology.

METHODS

A retrospective study of patients presenting serious bacterial keratitis was conducted over 32 months. Clinical features (age, risk factors, description, and visual acuity), progression, and bacteriological characteristics were statistically analyzed.

RESULTS

Seventy-three patients were hospitalized from January 2000 to August 2003. The mean age was 43.6 years old. The mean delay for referral was 6 days. Risk factors were noted in 93.1% of cases: contact lens wear (50% of risk factors); keratopathy (25%); corneal trauma (8.8%); general disease (8.8%); and corneal surgery (7.3%). Bacteriological cultures of corneal smears isolated an organism in 57.7% of cases. Pseudomonas aeruginosa (29.2%) and coagulase-negative Staphylococcus (22.9%) were the most frequent species. Gram-negative bacilli and Gram-positive cocci were also present. Gram-negative bacilli were largely dominant when associated with contact lenses (59.3% of bacteria in contact lens-related keratitis). Visual outcome was significantly correlated with anterior chamber inflammation and initial poor visual acuity.

DISCUSSION

In this study, Gram-negative bacilli keratitis appeared to be clearly dominant in cases of contact lens wear. This fact is complementary to the increase in Gram-positive cocci in developed countries, even with contact lens wear.