J Korean Ophthalmol Soc.  2020 Dec;61(12):1414-1423. 10.3341/jkos.2020.61.12.1414.

Age-related Clinical Analysis of Bacterial Keratitis in Daejeon and Chungcheong Provinces: a Multicenter Study

• Yoon JS
• Lee Ju
• Lee J
• Kim JE
• Lee H
• Kim HT
• Cho KJ
• Jung MS
• Choi SH
• Ko BY

• KMID: 2511282
• DOI: http://doi.org/10.3341/jkos.2020.61.12.1414

Abstract

Purpose
The purpose of this study was to investigate the age-related clinical features, risk factors, and prognoses of bacterial keratitis in Daejeon and Chungcheong provinces and the patterns and trends of fluoroquinolone antibiotic susceptibility.
Methods
Medical records of 433 patients (433 eyes) who visited one of the five university hospitals in Daejeon and Chungcheong provinces and were diagnosed as culture-positive bacterial keratitis between January 2000 to December 2018 were reviewed retrospectively. The patients were divided into younger and older groups based on an age of 60 years. Predisposing factors, prognostic factors, treatment method, causative organisms, and susceptibility to fluoroquinolone were analyzed.
Results
Two hundred seventy three males (63.0%) and 160 females (37.0%) were included. The most common risk factors in the younger group were contact lens wear (27.5%) and trauma and foreign body (27.0%). The most common risk factors in the older group were trauma and foreign body (30.5%). Staphylococcus species was the most common causative Gram-positive bacteria, regardless of age, and Pseudomonas species was the most common among Gram-negative bacteria. The older group tended to have more severe keratitis required more surgical treatment and had a worse visual outcome than the younger group (p < 0.05). As of 2011, the resistance to fluoroquinolone did not differ significantly between the groups (p > 0.05).
Conclusions
Bacterial keratitis in Daejeon and Chungcheong provinces indicated more severe clinical aspects and worse prognoses in older patients showing similar results from previous studies. Caution regarding trauma and foreign bodies and managing previous ocular disease is necessary for all age groups. Education regarding adequate contact lens care and hygiene is required for younger (<60 years) patients.

Keyword

Age-related; Antibiotic susceptibility; Bacterial keratitis; Prognosis; Risk factors