Aetiology of microbial keratitis in northern Tanzania

Poole, T R G; Hunter, D L; Maliwa, E M K; Ramsay, Andrew

doi:10.1136/bjo.86.8.941

Cited by 35 publications

(30 citation statements)

References 5 publications

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“…Among the bacteria isolated, Gram-positive cocci continue to be the most frequent agent, with a similar rate compared to the other studies in both elderly and age-independent series (17,20,26,(28)(29)(32)(33)(34)(35)(38)(39)(40)(41)(42)(43) . The incidence of Gram-negative bacilli was a little higher, which could be explained by geographical variation in the microbial flora of our patients (2,(14)(15)44) .…”

Section: Microbiologysupporting

confidence: 51%

Microbial keratitis in the elderly: a 32-year review

Passos¹,

Cariello²,

Yu³

et al. 2010

Arq. Bras. Oftalmol.

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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

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Section: Microbiologysupporting

confidence: 51%

Microbial keratitis in the elderly: a 32-year review

Passos¹,

Cariello²,

Yu³

et al. 2010

Arq. Bras. Oftalmol.

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“…Ninety-two people had received one or more identifiable treatments prior to admission: chloramphenicol (49), ciprofloxacin (18), tetracycline (9), gentamicin (15), povidone Iodine (12) and econazole (4). Twenty-nine (17.1%) people reported topical steroid treatment.…”

Section: Clinical Historymentioning

confidence: 99%

“…14,15 Moreover, given the severity of this problem, in contrast to South Asia, there are surprisingly few reports on the microbiology, clinical management and particularly the outcomes of microbial keratitis in Africa. [10][11][12][16][17][18] The purpose of this retrospective study was to audit the management and outcomes of patients admitted to Kilimanjaro Christian Medical Centre (KCMC) over a two-year period. Additionally, half-way through this period we introduced a management protocol for the admitting doctors, which we wanted to evaluate.…”

Section: Introductionmentioning

confidence: 99%

Microbial Keratitis in East Africa: Why are the Outcomes so Poor?

Burton¹,

Pithuwa²,

Okello³

et al. 2011

Ophthalmic Epidemiology

130

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Purpose-Microbial keratitis (MK) is a major cause of blindness in Africa. This study reports the epidemiology, causative organism, management and outcome of MK in people admitted to a large referral hospital in Northern Tanzania, and explores why the outcomes are so poor for this condition.Methods-A retrospective review of all admissions for MK during a 27-month period. Information was collected on: demographics, history, examination, microbiology, treatment and outcome.Results-170 patients with MK were identified. Presentation was often delayed (median 14 days), and more delayed if another health facility was visited first (median 21 days). Appropriate intensive antibiotic treatment was prescribed in 19% before admission. Lesions were often severe (41% >5mm). Filamentary fungi were detected in 25% of all specimens (51% of specimens with a positive result). At discharge 66% of affected eyes had a visual acuity of less than 6/60. Perforations developed in 30% and evisceration was necassary in 8%. Perforation was associated with large lesions and visiting another health facility. HIV infection was diagnosed in 16% of individuals tested, which is approximately twice the prevalence found in the wider population.Conclusions-Microbial keratitis is a significant clinical problem in this region, which generally has a very poor outcome. Delayed presentation is a critical issue. Fungal keratitis is a prominent cause and there is an indication that HIV may increase susceptibility. Prompt recognition and appropriate treatment in primary / secondary health facilities and rapid referral when needed may reduce the burden of blindness from this disease.

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“…Its incidence ranges from 6% to 20% of all microbial keratitis, and is seen in about 50% in culture-proven cases [9,10]. Traditionally, it is considered a disease of rural areas and is frequently caused by trauma with vegetative material.…”

Section: Epidemiology Of Fungal Keratitismentioning

confidence: 99%

Fungal Keratitis - A Brief Overview

Malhotra¹

2015

OCR

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Aetiology of microbial keratitis in northern Tanzania

Cited by 35 publications

References 5 publications

Microbial keratitis in the elderly: a 32-year review

Microbial keratitis in the elderly: a 32-year review

Microbial Keratitis in East Africa: Why are the Outcomes so Poor?

Fungal Keratitis - A Brief Overview

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