Ophthalmology Department, Gold Coast University Hospital, Southport, Australia.
School of Optometry and Vision Science, University of New South Wales, Australia.
Cornea. 2019 Dec;38(12):1519-1523. doi: 10.1097/ICO.0000000000002053.
To estimate the incidence and define the demographic and microbiological profile of pediatric microbial keratitis (MK) in Queensland, Australia.
This is a retrospective study based on the multicenter database of all patients with positive corneal scrapes in Queensland, Australia, between 2005 and 2015. Pathology organizations in Queensland were identified by online and local directory search and were requested to provide digital records of the corneal scrapes, including patient demographics and culture and antibiotic sensitivity results. Patient demographics, yearly incidence (based on state population data), cultured organisms, and antibiotic sensitivities in MK in patients 16 years old or younger with keratitis were reported and compared with adults.
Pediatric cases comprised 125 cases of a total 3182 (3.9%) included in the database. The yearly incidence of MK in children was estimated to be 0.11 cases per 10,000 people 16 years old or younger (95% confidence interval, 0.086-0.134), which was significantly lower than the estimated incidence in people older than 16 years (0.82 per 10,000 people; 95% confidence interval, 0.72-0.92; P < 0.0001). The average age of pediatric patients was 9.2 years (SD 5.5). Culture results showed Gram-positive organisms were the most common causative organisms (84%; 67.2%), Pseudomonas aeruginosa was the most common single organism (24%; 19.2%), and fungal recovery was low (4%; 3.2%). Cultures positive for Streptococcus pneumoniae (17%; 13.6%; P < 0.001) and bacteria sensitive to all recorded antibiotics (96.8%; P < 0.001) were significantly more common in children.
MK in pediatric patients is less common than in adults. Although Streptococcus pneumoniae was more common in children, P. aeruginosa was the most common isolate.
估计澳大利亚昆士兰州儿科微生物角膜炎(MK)的发病率,并确定其人口统计学和微生物学特征。
这是一项基于澳大利亚昆士兰州 2005 年至 2015 年间所有阳性角膜刮片患者的多中心数据库的回顾性研究。通过在线和本地目录搜索确定昆士兰州的病理组织,并要求其提供角膜刮片的数字记录,包括患者人口统计学资料以及培养物和抗生素敏感性结果。报告并比较了 16 岁以下角膜炎患者的 MK 患者的人口统计学资料、年发病率(基于州人口数据)、培养的微生物和抗生素敏感性。
儿科病例占数据库中 3182 例(3.9%)的 125 例。估计 16 岁以下儿童 MK 的年发病率为每 10000 人 0.11 例(95%置信区间,0.086-0.134),明显低于 16 岁以上人群的估计发病率(0.82 例/10000 人;95%置信区间,0.72-0.92;P<0.0001)。儿科患者的平均年龄为 9.2 岁(标准差 5.5)。培养结果显示,革兰氏阳性菌是最常见的病原体(84%;67.2%),铜绿假单胞菌是最常见的单一病原体(24%;19.2%),真菌回收率较低(4%;3.2%)。肺炎链球菌(17%;13.6%;P<0.001)和对所有记录抗生素敏感的细菌(96.8%;P<0.001)的培养阳性率在儿童中明显更高。
儿科患者的 MK 比成人少见。尽管儿童中肺炎链球菌更为常见,但铜绿假单胞菌是最常见的分离株。