Comparison of Culture-Positive and -Negative Microbial Keratitis

• Published in: Turk oftalmoloji gazetesi Vol. 52; no. 1; pp. 1 - 5
• Main Authors: Yarımada, Semir, Barut Selver, Özlem, Palamar, Melis, Eğrilmez, Sait, Aydemir, Sabire Şöhret, Hilmioğlu Polat, Süleyha, Yağcı, Ayşe
• Format: Journal Article
• Language: English
• Published: Turkey Galenos Yayinevi Tic. Ltd 01.02.2022; Türk Oftalmoloji Derneği; Galenos Publishing House; Galenos Publishing; Galenos Yayinevi
• Subjects: Antibiotics; Bacteria; Bacterial infections; Bacterial pneumonia; Comparative analysis; contact lens; Cornea; culture; Disease; Eye surgery; Fungi; Gram-positive bacteria; Health aspects; Keratitis; Laboratories; Medical records; microbial keratitis; Microorganisms; Original; Pneumonia; Risk factors; Statistical analysis; Streptococcus infections; Tıp; İstanbul; Türkiye; United States > US; Turkey; Contact lens; culture; microbial keratitis
• ISSN: 1300-0659; 2149-8695; 2149-8709; 2147-2661
• DOI: 10.4274/tjo.galenos.2021.98046

To evaluate and compare the risk factors, presenting features, and outcomes of patients with culture-positive and culture-negative microbial keratitis (MK) who presented to a tertiary referral center. We conducted a retrospective review of the medical records of 314 patients who were diagnosed with MK in our clinic between 2012 and 2019. Among 314 patients, 142 had positive cultures (45.2%). The mean ages of the culture-positive and -negative patients at the time of diagnosis were 51.39±21.31 (range, 14-90) years and 56.68±21.34 (7-94) years, respectively (p=0.028). The mean best corrected visual acuity (BCVA) of the culture-positive and -negative patients were1.74±1.25 (0-3.1) LogMAR and 1.91±1.23 (0-3.1) LogMAR prior to treatment and increased to 1.21±1.30 (0-3.1) LogMAR and 1.27± 1.29 (0-3.1) LogMAR at last visit, respectively. There was no statistically significant difference between culture-positive and -negative patients' BCVA levels at presentation or last visit. Ninety-two patients (64.7%) were infected with bacteria and 50 patients (35.2%) with fungi. The most common pathogen was (18.3%), followed by (11.2%) and spp. (11.2%). Keratitis foci were either centrally or paracentrally located in 105 eyes (73.9%) of culture-positive patients and 149 eyes (86.6%) of culture-negative patients. Multiple foci were present mostly in culture-positive patients (p=0.001). There was no significant difference between the culture-positive and -negative groups in terms of hypopyon presence (p=0.364). The proportion of contact lens (CL) wearers was 33% (n=47) among culturepositive MK patients and 13.3% (n=23) among culture-negative MK patients, respectively (p<0.001). Culture positivity was found to be significantly higher in keratitis associated with CL use (p=0.0001). Microbiological analysis and culture evaluation are important steps in order to manage proper treatment in microbial keratitis. Prognosis mostly depends on the infectivity of the microbiological agent.