Aruljyothi Lokeshwari, Radhakrishnan Naveen, Prajna Venkatesh N, Lalitha Prajna
Department of Cornea and Refractive Services, Aravind Eye Hospital, Madurai, Tamil Nadu, India.
Department of Ocular Microbiology, Aravind Eye Hospital, Madurai, Tamil Nadu, India.
Br J Ophthalmol. 2016 Dec;100(12):1719-1723. doi: 10.1136/bjophthalmol-2015-307631. Epub 2016 Feb 25.
To study the risk factors, microbiological profile and clinical outcomes of infectious keratitis affecting paediatric patients.
Retrospective case series.
Review of case records of paediatric patients (0-16 years) diagnosed with infectious keratitis who presented to Aravind Eye Hospital, Madurai, India during January 2011 to December 2013. Demographic details, predisposing factors, microbiological investigations, clinical course and visual outcome were analysed.
In this time period, 240 eyes of 234 children had a diagnosis of infectious keratitis. One hundred and twenty-five (53.4%) children had a history of trauma. Smears were obtained in 220 eyes, while culture was performed in 191 eyes. The culture results were positive in 142 (74.3%) eyes. Fungi was the most common infectious agent isolated in culture (54.2%) followed by bacteria (40.8%) and acanthamoeba (2.1%). Successful healing of the keratitis with appropriate medical therapy occurred in 223 (92.9%) eyes, while 17 (7.1%) eyes required therapeutic keratoplasty. Of the 151 patients with preliminary and final visual acuity, vision improved by 2 lines in 68 eyes (45%), stayed the same in 75 eyes (49.6%) and worsened in 8 eyes (5.3%).
Contrary to previous reports, fungi are the most common aetiological organism in the causation of infectious keratitis in children in our study population. Fusarium was the most common fungal species isolated. These data are similar to the data obtained from adult patients with infectious keratitis in this region. While microbiological investigations are important to initiate appropriate antimicrobial therapy, the findings from our study need to be kept in mind, especially while initiating empirical therapy in this population.
研究影响小儿患者的感染性角膜炎的危险因素、微生物学特征及临床结局。
回顾性病例系列研究。
回顾2011年1月至2013年12月期间在印度马杜赖阿拉文德眼科医院就诊的诊断为感染性角膜炎的小儿患者（0至16岁）的病例记录。分析人口统计学细节、易感因素、微生物学检查、临床病程及视力结局。
在此期间，234名儿童的240只眼诊断为感染性角膜炎。125名（53.4%）儿童有外伤史。220只眼进行了涂片检查，191只眼进行了培养。培养结果在142只眼（74.3%）呈阳性。真菌是培养中分离出的最常见感染病原体（54.2%），其次是细菌（40.8%）和棘阿米巴（2.1%）。223只眼（92.9%）经适当药物治疗后角膜炎成功愈合，17只眼（7.1%）需要治疗性角膜移植术。在151名有初始和最终视力的患者中，68只眼（45%）视力提高了2行，75只眼（49.6%）视力不变，8只眼（5.3%）视力恶化。
与既往报道相反，在我们的研究人群中，真菌是小儿感染性角膜炎最常见的病原体。镰刀菌是分离出的最常见真菌种类。这些数据与该地区成人感染性角膜炎患者的数据相似。虽然微生物学检查对于启动适当的抗菌治疗很重要，但我们的研究结果需要牢记，尤其是在对该人群启动经验性治疗时。
