感染性角膜炎是一种威胁视力的疾病,通常是眼部急症。视觉结果取决于及时和准确的临床管理以及地理和流行病学意识。我们进行了一项回顾性观察研究,以确定流行病学和实验室概况,以及圣保罗三级医院细菌性角膜炎的临床病程超过2年。关于年龄的信息,性别,诱发因素,局部和手术治疗,视敏度,溃疡分类,细菌镜,文化,并收集抗生素敏感性试验。这项研究包括160名患者。平均年龄为65.1±18.4岁,在83.1%的患者中发现了危险因素。经验性局部强化头孢菌素与氨基糖苷或第四代氟喹诺酮可治愈66.2%的病例。平均治疗时间为22.5±9天。视力的平均变异为-0.25logMAR,p<0.001。培养显示64%的革兰氏阳性细菌。所有革兰阳性菌均对头孢菌素敏感,万古霉素,和喹诺酮类药物.所有革兰阴性菌均对庆大霉素敏感,妥布霉素,阿米卡星,还有环丙沙星.这些发现加强了使用强化的头孢菌素和氨基糖苷或第四代氟喹诺酮对严重角膜溃疡进行及时经验性治疗的重要性,因为它们同样有效。收集的数据不足以评估该人群中眼感染随时间的抵抗力。
Infectious keratitis is a sight-threatening condition that is usually an ocular emergency. The visual outcome depends on prompt and accurate clinical management as well as geographic and epidemiological awareness. We conducted a retrospective observational study to define the epidemiological and laboratory profile, as well as the clinical course of bacterial keratitis in a tertiary hospital in São Paulo over 21 years. Information about age, sex, predisposing factors, topical and surgical treatment, visual acuity, ulcers\' classification, bacterioscopy, culture, and antibiotic sensitivity tests were collected. This study included 160 patients. The mean age was 65.1 ± 18.4 years and risk factors were identified in 83.1 % of the patients. Empirical topical fortified cephalosporin with an aminoglycoside or fourth-generation fluoroquinolone was curative for 66.2 % of the cases. The mean treatment duration was 22.5 ± 9 days. The mean variation of visual acuity was -0.25 logMAR, p < 0.001. Culture revealed 64 % of Gram-positive bacteria. All Gram-positive bacteria were sensitive to cephalothin, vancomycin, and quinolones. All Gram-negative bacteria were sensitive to gentamicin, tobramycin, amikacin, and ciprofloxacin. These findings reinforce the importance of prompt empirical treatment of severe corneal ulcers with a fortified cephalosporin and aminoglycoside or a fourth-generation fluoroquinolone as there are equally effective. Collected data was insufficient to evaluate resistance of ocular infections over time in this population.