Abstract：
OBJECTIVE: To report an epidemiological update of bacterial keratitis (BK) in a tertiary ophthalmology centre over 20 months compared with a previous study on the same timeframe from 1998 to 1999.
METHODS: 354 patients with BK documented by microbiological corneal scraping or resolutive under antibiotics treatment from January 2020 to September 2021 were analysed retrospectively.
RESULTS: One or several risk factors were found in 95.2% of patients: contact lens wear (45.2%), ocular surface disease (25.0%), systemic disease (21.8%), ocular trauma (11.9%) and ocular surgery (8.8%). The positivity rate of corneal scrapings was 82.5%, with 18.2% polybacterial. One hundred seventy-five (59.9%) bacteria were Gram-negative, and 117 (40.1%) were Gram-positive. The most common bacteria were Pseudomonas aeruginosa (32.5%), Moraxella spp (18.1%) and Staphylococcus aureus (8.2%). Final visual acuity (logarithm of the minimum angle of resolution) was associated with age (r=+0.48; p=0.0001), infiltrate size (r=+0.32; p<0.0001), ocular surface disease (r=+0.13; p=0.03), ocular trauma (r=-0.14; p=0.02) and contact lens wear (r=-0.26; p<0.0001). Gram-negative bacteria were responsible for deeper (r=+0.18; p=0.004) and more extensive infiltrates (r=+0.18; p=0.004) in younger patients (r=-0.19; p=0.003). Compared with the previous period, the positivity rate of corneal scrapings and the proportion of Gram-negative bacteria, especially Moraxella spp, increased. All P. aeruginosa and Moraxella spp were sensitive to quinolones, and all S. aureus were sensitive to both quinolones and methicillin.
CONCLUSIONS: Contact lens wear remained the leading risk factor. The bacteria distribution was reversed, with a predominance of Gram-negative bacteria and increased Moraxella spp.
METHODS: 354 patients with BK documented by microbiological corneal scraping or resolutive under antibiotics treatment from January 2020 to September 2021 were analysed retrospectively.
RESULTS: One or several risk factors were found in 95.2% of patients: contact lens wear (45.2%), ocular surface disease (25.0%), systemic disease (21.8%), ocular trauma (11.9%) and ocular surgery (8.8%). The positivity rate of corneal scrapings was 82.5%, with 18.2% polybacterial. One hundred seventy-five (59.9%) bacteria were Gram-negative, and 117 (40.1%) were Gram-positive. The most common bacteria were Pseudomonas aeruginosa (32.5%), Moraxella spp (18.1%) and Staphylococcus aureus (8.2%). Final visual acuity (logarithm of the minimum angle of resolution) was associated with age (r=+0.48; p=0.0001), infiltrate size (r=+0.32; p<0.0001), ocular surface disease (r=+0.13; p=0.03), ocular trauma (r=-0.14; p=0.02) and contact lens wear (r=-0.26; p<0.0001). Gram-negative bacteria were responsible for deeper (r=+0.18; p=0.004) and more extensive infiltrates (r=+0.18; p=0.004) in younger patients (r=-0.19; p=0.003). Compared with the previous period, the positivity rate of corneal scrapings and the proportion of Gram-negative bacteria, especially Moraxella spp, increased. All P. aeruginosa and Moraxella spp were sensitive to quinolones, and all S. aureus were sensitive to both quinolones and methicillin.
CONCLUSIONS: Contact lens wear remained the leading risk factor. The bacteria distribution was reversed, with a predominance of Gram-negative bacteria and increased Moraxella spp.
摘要：
目的：报告某三级眼科中心20个月以来细菌性角膜炎（BK）的流行病学最新情况，与1998年至1999年同期的一项研究进行比较。
方法：对2020年1月至2021年9月期间因微生物角膜刮除或抗生素治疗下解决的354例BK患者进行回顾性分析。
结果：在95.2％的患者中发现了一种或几种危险因素：隐形眼镜佩戴（45.2％），眼表疾病（25.0%），全身性疾病（21.8%），眼外伤(11.9%)和眼科手术(8.8%)。角膜刮片阳性率为82.5%,18.2％的多细菌。一百七十五（59.9％）细菌为革兰氏阴性，和117（40.1%）为革兰氏阳性。最常见的细菌是铜绿假单胞菌(32.5%),莫拉菌(18.1%)和金黄色葡萄球菌(8.2%)。最终视力（最小分辨率角度的对数）与年龄相关（r=0.48；p=0.0001），渗透物大小(r=+0.32；p<0.0001)，眼表疾病（r=0.13；p=0.03），眼外伤（r=-0.14；p=0.02）和隐形眼镜佩戴（r=-0.26；p<0.0001）。在年轻患者（r=-0.19；p=0.003）中，革兰氏阴性菌导致更深层（r=0.18；p=0.004）和更广泛的浸润（r=0.18；p=0.004）。与上一期相比,角膜刮片的阳性率和革兰氏阴性菌的比例，尤其是莫拉氏菌属,增加。所有铜绿假单胞菌和莫拉菌对喹诺酮类药物敏感，所有金黄色葡萄球菌对喹诺酮类药物和甲氧西林均敏感。
结论：佩戴隐形眼镜仍然是主要的危险因素。细菌分布逆转，以革兰氏阴性菌为主，莫拉氏菌属增加。
方法：对2020年1月至2021年9月期间因微生物角膜刮除或抗生素治疗下解决的354例BK患者进行回顾性分析。
结果：在95.2％的患者中发现了一种或几种危险因素：隐形眼镜佩戴（45.2％），眼表疾病（25.0%），全身性疾病（21.8%），眼外伤(11.9%)和眼科手术(8.8%)。角膜刮片阳性率为82.5%,18.2％的多细菌。一百七十五（59.9％）细菌为革兰氏阴性，和117（40.1%）为革兰氏阳性。最常见的细菌是铜绿假单胞菌(32.5%),莫拉菌(18.1%)和金黄色葡萄球菌(8.2%)。最终视力（最小分辨率角度的对数）与年龄相关（r=0.48；p=0.0001），渗透物大小(r=+0.32；p<0.0001)，眼表疾病（r=0.13；p=0.03），眼外伤（r=-0.14；p=0.02）和隐形眼镜佩戴（r=-0.26；p<0.0001）。在年轻患者（r=-0.19；p=0.003）中，革兰氏阴性菌导致更深层（r=0.18；p=0.004）和更广泛的浸润（r=0.18；p=0.004）。与上一期相比,角膜刮片的阳性率和革兰氏阴性菌的比例，尤其是莫拉氏菌属,增加。所有铜绿假单胞菌和莫拉菌对喹诺酮类药物敏感，所有金黄色葡萄球菌对喹诺酮类药物和甲氧西林均敏感。
结论：佩戴隐形眼镜仍然是主要的危险因素。细菌分布逆转，以革兰氏阴性菌为主，莫拉氏菌属增加。
