J Korean Ophthalmol Soc.  2011 Jan;52(1):14-22. 10.3341/jkos.2011.52.1.14.

Clinical Aspect and Prognosis of Staphylococcus Epidermidis Keratitis

• Kim BK
• Lee DW
• Cho NC
• You IC

• KMID: 2214132
• DOI: http://doi.org/10.3341/jkos.2011.52.1.14

Abstract

PURPOSE
To investigate the predisposing factors, clinical manifestations, treatment results and risk factors for treatment failure in Staphylococcus epidermidis keratitis.
METHODS
Sixty-one eyes of 61 patients who were diagnosed with Staphylococcus epidermidis keratitis were included in the present study. The past history, location and size of ulceration, hypopyon, treatment results, and antibiotic susceptibility were reviewed retrospectively. A logistic regression analysis was performed to identify the main prognostic risk factors for treatment failure.
RESULTS
Twenty-six eyes (42.6%) had previous histories of corneal traumas. Polymicrobial infections were observed in 31 cases (50.8%), including 11 cases (35.5%) combined with the Fusarium species. Twenty-five eyes (41.0%) had lesions located at the corneal center. The average size of ulceration was 7.3 +/- 7.2 mm2. Thirteen eyes (21.3%) with lesions that progressed or occurred in the corneal perforation underwent evisceration, penetrating keratoplasty or scleral graft. Risk factors for treatment failure were a history of previous keratitis (P = 0.003) and an ulcer exceeding 5.0 mm2 in size (P = 0.018).
CONCLUSIONS
Staphylococcus epidermidis keratitis usually has a good prognosis, although a history of previous keratitis and a large ulcer size are risk factors for treatment failure.

Keyword

Prognosis; Risk factor; Staphylococcus epidermidis keratitis; Treatment failure

MeSH Terms

Coinfection
Corneal Perforation
Eye
Fusarium
Humans
Keratitis
Keratoplasty, Penetrating
Logistic Models
Prognosis
Retrospective Studies
Risk Factors
Staphylococcus
Staphylococcus epidermidis
Transplants
Treatment Failure
Ulcer

Figure

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  Figure 1. Age distribution of Staphylococcus epidermidis keratitis.

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  Figure 2. Seasonal variation of patients with Staphylococcus epidermidis keratitis.

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  Figure 3. (A) Anterior segment photograph of a 46-year-old woman, who had a history of corneal trauma at the first visit. Mild conjunctival injection and corneal infiltration were observed. The lesion was completely healed in 2 weeks with antimicrobial therapy. (B) Anterior segment photograph of an 89-year-old woman, who had a history of keratitis at a first visit. Slit-lamp examination revealed severe conjunctival injection, corneal lysis with a size of approximately 4 mm, hypopyon, corneal edema, folding of the Descemet's membrane. Staphylococcus epidermidis and Fusarium were isolated by corneal scraping. Despite of antimicrobial and antifungal therapy, patient's ocular condition deteriorated and evisceration was ultimately performed.

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  Figure 4. Visual acuities of the eyes with Staphylococcus epidermidis keratitis in the first and last medical examinations.

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