Microbial keratitis—A review of epidemiology, pathogenesis, ocular manifestations, and management

Ezisi, Chinyelu Nkemdilim; Ogbonnaya, Chimdia; Okoye, Obiekwe; Ezeanosike, Edak; Ginger-Eke, Helen A; Arinze, Obinna C

doi:10.4103/njo.njo_2_18

Cited by 14 publications

(14 citation statements)

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“…4 Bacterial (staphylococcus, streptococcus and pseudomonas) and fungal 74 (fusarium and aspergillus) are the most common with an almost 50:50 proportion. [5][6][7][8][9][10][11]…”

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confidence: 99%

Delay Along the Care Seeking Journey of Patients with Microbial Keratitis in Uganda

Arunga

Kintoki

Gichuhi

et al. 2019

Ophthalmic Epidemiology

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Purpose To describe the care seeking journey and causes of delay among patients with Microbial Keratitis in Uganda. Methods A prospective cohort of patients presenting with microbial keratitis at the two main eye units in Southern Uganda (2016–2018). We collected information on demographics, home address, clinical history, and presentation pathway including, order of facilities where patients went to seek care, treatment advice, cost of care, and use of Traditional Eye Medicine. Presentation time was noted. We compared “direct” presenters versus “indirect” presenters and analysed predictors of delay. Results About 313 patients were enrolled. All were self-referred. Only 19% of the patients presented directly to the eye hospital. Majority (52%) visited one facility before presenting, 19% visited two facilities, 9% visited three facilities, and 2% visited four facilities. The cost of care increased with increase in the number of facilities visited. People in a large household, further distance from the eye hospital and those who used Traditional Eye Medicine were less likely to come directly to the eye hospital. Visiting another facility prior to the eye hospital and use of Traditional Eye Medicine aOR 1.58 (95%CI 1.03–2.43), p = .038 were associated with delayed presentation to the eye hospital. Conclusion This study provided information on patient journeys to seek care. Delay was largely attributable to having visited another health facility: a referral mechanism for microbial keratitis was non-existent. There is need to explore how these health system gaps can be strengthened.

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“…4 Bacterial (staphylococcus, streptococcus and pseudomonas) and fungal 74 (fusarium and aspergillus) are the most common with an almost 50:50 proportion. [5][6][7][8][9][10][11]…”

mentioning

confidence: 99%

Delay Along the Care Seeking Journey of Patients with Microbial Keratitis in Uganda

Arunga

Kintoki

Gichuhi

et al. 2019

Ophthalmic Epidemiology

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“…The prevalence of this condition varies across geographical locations depending on the type and causative factors. [ 4 23 ] In this study, bacterial keratitis accounted for majority (81.1%) of infectious cases, whereas fungal keratitis was found in 5 (5.6%) cases. This is similar to the report from Olawoye et al in Ibadan.…”

Section: Discussionmentioning

confidence: 62%

“…[ 4 ] Fungal keratitis has been reported to be more common in the developing nations because of the greater involvement in agricultural works posing increased exposure to vegetative matter. [ 7 14 23 ] The occupational distribution of our patients with high number of students and civil servants could account for the low prevalence of fungal keratitis in this study. Bacterial keratitis has been reported to be the most common form of microbial keratitis in the developed nations of the world.…”

Section: Discussionmentioning

confidence: 94%

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Pattern of corneal disorders in Ekiti: A tertiary eye center experience

2020

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Purpose: The cornea is the most significant refractive medium in the eye. Pathologies affecting the cornea usually have a great impact on vision. The etiology of corneal disorder varies from one geographical location to another. The objective of this study was to determine the pattern of corneal disorders at Ekiti State University Teaching Hospital, Ado-Ekiti. Materials and Methods: A retrospective study of case records of patients with cornea disorders over a 5-year period was carried out. Demographic characteristics, presenting visual acuity, and risk factor for cornea disorders were retrieved. Data were entered into the Statistical Package for the Social Sciences version 20, and statistical significance was inferred at P < 0.05. Results: Corneal disorders accounted for 3.3% of the eye disorders seen during the period of study. The median age was 37 years. Males outnumbered females giving a ratio of 1.9:1 and the age range from 0.25 to 92 years. There were more females than males in the 11–20 years’ age group. Students (84, 25.4%) and artisans (62, 18.8%) were the two leading occupational groups. Infectious cases constituted 27.2% of the cases. Visual acuity at presentation was <3/60 in 131 (39.7%) cases. Foreign body entry was the leading etiologic agent in 101 (30.6%) cases. Conclusion: Half of the patients were blind at presentation, and many of them presented after more than 1 week of the onset of symptoms. Corneal foreign body, trauma, and vernal keratoconjunctivitis were the leading known predisposing factors. There will be need to emphasize more on the role of protective eye devices among our people, especially those who engage in outdoor activities.

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“…[ 1 ] Bacterial keratitis is the most common form of keratitis in developed countries, usually arising from contact lens wear. [ 1a,2 ] Pseudomonas aeruginosa ( P. aeruginosa ) is one of the top three isolates in 13 of 20 studies. [ 1b ] The traditional treatment method, in over 90% of cases, [ 3 ] for MK is a broad spectrum of fortified antibiotic eye drops.…”

Section: Figurementioning

confidence: 99%

Poly‐ε‐Lysine or Mel4 Antimicrobial Surface Modification on a Novel Peptide Hydrogel Bandage Contact Lens

Lace

Doherty

Dutta

et al. 2020

Adv Materials Inter

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Microbial keratitis (MK) is a serious issue in many countries and is often caused by contact lens wear. Antimicrobial peptides (AMPs) are a potentially useful tool for creating antimicrobial surfaces in light of increasing antibiotic resistance. Poly‐ε‐lysine (pεK) is an AMP that has been used extensively as a food preservative and Mel4 has recently been synthesized and studied as an antimicrobial coating for contact lenses. A hydrogel synthesized of pεK cross‐linked with biscarboxylic acids provides a potential lens material which has many surface free amines, that can be subsequently used to attach additional AMPs, creating an antimicrobial lens. The aim of this study is to investigate pεK hydrogels against a clinical strain of Pseudomonas aeruginosa (P. aeruginosa) for preventing or treating MK. Covalent attachment of AMPs is investigated and confirmed by fluorescently tagged peptides. Bound pεK effectively reduces the number of adherent P. aeruginosa in vitro (>3 log). In ex vivo studies positive antimicrobial activity is observed on bare pεK hydrogels and those with additionally bound pεK or Mel4; lenses allow the maintenance of the corneal epithelium. A pεK hydrogel contact lens with additional AMPs can be a therapeutic tool to reduce the incidence of MK.

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Microbial keratitis—A review of epidemiology, pathogenesis, ocular manifestations, and management

Cited by 14 publications

References 1 publication

Delay Along the Care Seeking Journey of Patients with Microbial Keratitis in Uganda

Delay Along the Care Seeking Journey of Patients with Microbial Keratitis in Uganda

Pattern of corneal disorders in Ekiti: A tertiary eye center experience

Poly‐ε‐Lysine or Mel4 Antimicrobial Surface Modification on a Novel Peptide Hydrogel Bandage Contact Lens

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