Document Detail


A longitudinal study of trends in keratitis in Australia.
MedLine Citation:
PMID:  18245964     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To analyze the changes in risk factors, corneal culture results, antibiotic resistance, treatment, and clinical outcomes of patients with keratitis presenting to a major public hospital in Australia over a 5-year period. METHODS: A retrospective audit of all patients who had a corneal scraping between October 1999 and September 2004 at the Princess Alexandra Hospital. Clinical information was gathered from medical records and smear and culture results from the local microbiology database. The trends over time in patient demographics, keratitis risk factors, corneal culture results, antibiotic resistance, treatment, and clinical outcomes were analyzed by using linear regression. By using a moving average, we analyzed differences in the rate of culture of each causative organism for each month of the year with linear regression from the month of highest presentation. The mean of maximum temperatures on the days of presentation between different groups of organisms was compared. RESULTS: The proportion of patients presenting with keratitis related to contact lens wear increased significantly (12%-29%; P = 0.04) and with keratitis related to ocular surgery decreased significantly (18%-8%; P = 0.009) through the study. Antibiotic resistance of cultured bacteria to cephalothin increased significantly (2%-12%; P = 0.02), whereas resistance to ciprofloxacin and gentamicin remained at a low level throughout the study. There was significant variation in the monthly recovery of Pseudomonas aeruginosa (P = 0.04) and fungi (P = 0.02), which were cultured more frequently in summer months, whereas Streptococcus pneumoniae (P = 0.04) was more common in winter months than in other times of the year. Treatment with fluoroquinolones increased significantly (14%-40%; P = 0.002) through the study, and the rate of good outcomes also increased significantly (42%-72%; P = 0.02). CONCLUSIONS: In this series, keratitis related to contact lens wear became more frequent, whereas keratitis related to prior ocular surgery became less frequent. Different organism groups showed significant seasonal variations in their presentation, and bacterial resistance to cephalothin increased significantly.
Authors:
Matthew Green; Andrew Apel; Fiona Stapleton
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Cornea     Volume:  27     ISSN:  0277-3740     ISO Abbreviation:  Cornea     Publication Date:  2008 Jan 
Date Detail:
Created Date:  2008-02-04     Completed Date:  2008-03-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8216186     Medline TA:  Cornea     Country:  United States    
Other Details:
Languages:  eng     Pagination:  33-9     Citation Subset:  IM    
Affiliation:
Gold Coast Hospital, Southport, Australia. matdgreen@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Anti-Bacterial Agents / therapeutic use
Australia / epidemiology
Bacteria / isolation & purification
Cornea / microbiology
Corneal Ulcer / drug therapy,  epidemiology*,  microbiology
Drug Resistance, Bacterial
Eye Infections, Bacterial / drug therapy,  epidemiology*,  microbiology
Eye Infections, Fungal / drug therapy,  epidemiology*,  microbiology
Fungi / isolation & purification
Humans
Longitudinal Studies
Retrospective Studies
Risk Factors
Seasons
Treatment Outcome
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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