Microbial keratitis in the elderly: a 32-year review

Abstract

Purpose: To describe the demographic characteristics, associated factors and causative agents of infectious keratitis in the elderly in a tertiary referral center in São Paulo, Brazil. Methods: A retrospective review of all patients aged 60 years and over with a presumptive diagnosis of infectious keratitis who had material collected for microbiological analysis, between the years 1975 and 2007 (32-year span). Results: From a total of 7,060 age-independent cases of microbial keratitis, 1,545 cases in the elderly were reviewed, which had a mean age of 71.0 ± 7.8 years, ranging from 60 to 101 years. There were 707 males (45.6%) and 838 females (54.3%). Associated factors were: past ocular surgery (25.1%), ocular trauma (7.2%) and contact lens use (3.0%). Bacterioscopy was positive in 40.5% of cases. Culture positivity for any agent was 53.5% (bacteria 47.0%, fungi 6.1%, Acanthamoeba 0.4%). The most frequent bacteria were the grampositive cocci (mostly coagulase-negative Staphylococci) and gram-negative bacilli (mostly the genera Pseudomonas, Moraxella and Proteus), while the most frequent fungi were the filamentous (mostly the genus Fusarium). Conclusions: This study represents a large series of microbial keratitis in the elderly in a single referral center. The most important factor associated with this condition in the elderly was past ocular surgery. The most frequent causative agents were bacteria, especially gram-positive cocci and gram-negative bacilli. Keywords

Microbiological and epidemiological study of infectious keratitis in children and adolescents

“…It is a preventable cause of visual impairment, similar to including amblyopia in children and mono-or bilateral blindness (1)(2)(3) . More than one-third of eye injuries among children and adolescents result from their natural curiosity, immature motor skills, and tendency to imitate adult behavior without assessing the risks relevant to their actions.…”

Queratitis por Lasiodiplodia theobromae: comunicación de un caso y revisión de la literatura

“…En Brasil, en un estudio retrospectivo de 32 años sobre queratitis en adultos mayores se mencionan dos casos causados por este hongo 4 . En Ghana, L. theobromae ha sido asociada a 5,5% de las queratitis micóticas y en India entre 0,3% y 3,9% 21,30 .…”

“…Dentro de las etiologías, las de origen fúngico se presentan desde 6 a 60%, dependiendo principalmente de la localización geográfica [2][3][4][5] . Se considera una infección oportunista asociada principalmente a trauma ocular con materiales vegetales.…”

“…y Aspergillus spp. son los agentes etiológicos de mayor frecuencia [2][3][4][5][6][7] . En cambio, en países desarrollados la causa principal se relaciona al uso de lentes de contacto, siendo más frecuente la infección por levaduras, como Candida spp 6 .…”

Recognition of Corynebacterium pseudodiphtheriticum by Toll-like receptors and up-regulation of antimicrobial peptides in human corneal epithelial cells

“…A study on the microbial keratitis among the elderly also reported an increase in Corynebacterium infection from 0.7% to 11% over last 3 decades. 4 Others have also reported several cases of Corynebacterium keratitis in last few years and the numbers of cases are on the rise. [5][6][7] C. pseudodiphtheriticum is Gram-positive aerobic or facultative anaerobic bacilli found ubiquitously in food, water and soil.…”