The Asia Cornea Society Infectious Keratitis Study: A Prospective Multicenter Study of Infectious Keratitis in Asia

Khor, Wei-Boon; Prajna, Venkatesh; Garg, Prashant; Mehta, Jodhbir S.; Xie, Lixin; Liu, Zuguo; Padilla, Ma. Dominga B.; Joo, Choun‐Ki; Inoue, Yoshitsugu; Goseyarakwong, Panida; Hu, Fung-Rong; Nishida, Kohji; Kinoshita, Shigeru; Puangsricharern, Vilavun; Tan, A.; Beuerman, Roger W.; Young, Alvin L.; Sharma, Namrata; Haaland, Benjamin; Mah, Francis S.; Tu, Elmer Y.; Stapleton, Fiona; Abbott, Richard L.; Tan, Donald

doi:10.1016/j.ajo.2018.07.040

Cited by 167 publications

(165 citation statements)

References 28 publications

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“…Recent epidemiologic study conducted in Asia reported that the incidence of FK was higher in India and China and was lesser in other Asian countries such as Taiwan [13]. In contrast, our results showed a higher FK identification rate in Taiwan.…”

Section: Table 3 Mycology and Bacteriology Of The Patients With Defincontrasting

confidence: 82%

“…However, there is a paucity of studies that directly compare the difference between subtropical and tropical area in the same country. To date, most large-scale epidemiologic studies on MK in Taiwan were performed in subtropical area [12][13][14]. These local information cannot be generalized to different geographical locations and climate zones.…”

Section: Annals Of Clinical Microbiology and Antimicrobialsmentioning

confidence: 99%

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Comparison of fungal and bacterial keratitis between tropical and subtropical Taiwan: a prospective cohort study

Chen

Hsu

Hsiao

et al. 2020

Ann Clin Microbiol Antimicrob

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Background: Fungal keratitis (FK) has been shown to be a climate-sensitive disease. The differentiation between FK from bacterial keratitis (BK) was difficult. The purpose of this study was to compare the bacteriology and mycology between tropical and subtropical Taiwan and to investigate the independent risk factors for identification of fungi from bacteria. Methods: Two hundred ninety-seven patients with clinical suspected microbial keratitis were prospectively enrolled. A fungal to bacteria rate (FBR), the number of fungi divided by bacteria identified, was determined to estimate the prevalence of fungi and bacteria. Clinical presentation, profiles of microorganisms, and predisposing risk factors were determined. Univariate and multivariate logistic regression analysis were used to investigate the independent risk factors. Results: A total of 82 fungi and 143 bacteria were laboratory confirmed. The identification rate of fungus was higher in tropical Taiwan (p = 0.010). Among the fungi and bacteria confirmed, the FBR was 0.29 (22.4% vs. 77.6%) in subtropical Taiwan, and 0.70 (41.3% vs. 58.7%) in tropical Taiwan. Samples obtained in tropical area (p = 0.019), ocular trauma (p = 0.019), and plant exposure (p = 0.003) were independent risk factors for identification of fungus from bacteria. The predominant fungus isolated from corneal scraping were Fusarium solani (25%) and Trichosporon faecale (25%) in subtropical Taiwan; in tropical Taiwan was Fusarium spp. (50%). Conclusions: The identification rate of fungus was higher in tropical Taiwan than subtropical Taiwan. Awareness of the local epidemiology is crucial for early diagnosis of fungal keratitis in tropical area.

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Section: Table 3 Mycology and Bacteriology Of The Patients With Defincontrasting

confidence: 82%

Section: Annals Of Clinical Microbiology and Antimicrobialsmentioning

confidence: 99%

Comparison of fungal and bacterial keratitis between tropical and subtropical Taiwan: a prospective cohort study

Chen

Hsu

Hsiao

et al. 2020

Ann Clin Microbiol Antimicrob

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“…We did not find multidrug resistance strains (i.e.methicillin-resistant Staphylococcus aureus or MRSA) which was different from previous studies from India and Japan, which reported high rate of antibiotic resistance in viridans streptococci 20 and significant high incidence of methicillin-resistant Staphylococcus infection 8 . The variation of antibiotic-resistant patterns in each country may be related to different bacterial distribution, patterns of antimicrobial use and antimicrobial resistance patterns in each country 22 .…”

Section: Discussionmentioning

confidence: 99%

Comparison of the ocular microbiome between chronic Stevens-Johnson syndrome patients and healthy subjects

Kittipibul

Puangsricharern

Chatsuwan

2020

Sci Rep

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Stevens -Johnson syndrome (SJS) has manifestation through the exfoliation of epidermis and mucosaltissue. Ocular surface is usually affected in acute and chronic stage. The patients are usually suffered from chronic ocular sequelae including symblepharon, limbal stem cell deficiency, etc. Furthermore, ocular microbiome may also be altered in SJS. This is prospective, age and sex matched analytical study which including 20 chronic SJS patients and 20 healthy subjects for specimen collection from inferior conjunctiva for microbiome analysis by conventional cultures and next-Generation Sequencing (nGS) methods. Significant higher proportion of positive-cultured specimen was demonstrated in SJS group (SJS group 60%, healthy 10%, p-value = 0.001). In addition, NGS which providing high-throughput sequencing has demonstrated the greater diversity of microbial species. the higher proportion of pathogenic microorganisms including Pseudomonas spp., Staphylococcus spp., Streptococcus spp., Acinetobacter spp. was shown in SJS group. ocular surface in SJS is usually occupied by more diverse microorganisms with increased proportion of pathogenic species. This condition may affect chronic inflammation and opportunistic infections in SJS group. In order to prevent and treat infection in these patients, appropriate antibiotics based on bacterial examination should be considered as the first-line treatment in the SJS patients.Stevens -Johnson syndrome (SJS) is an abnormal immune-mediated responses stimulated by medications such as sulfonamides, allopurinol, cold medicines including paracetamol 1 and systemic infections caused by virus and mycoplasma. Incidence of SJS is 1.2-6 out of 1,000,000 persons per year 2 . Although the incidence of diseases is low, the mortality rate is high ranging from 1% to 5% 2 . Patients usually present with severe, acute blistering disorders that affect the skin and mucous membranes involving oral mucosa and ocular surface 3 . Ocular involvement has been reported in 25-75% of SJS patients 2 . In the acute phase, patients usually develop conjunctivitis, corneal abrasion, and pseudo-membrane formation. While chronic ocular sequelae develop in 35% of cases, including eyelid irregularity, symblepharon formation, limbal stem cell deficiency (LSCD), and keratinization, leading to poor vision 2 .Recent interests are focused in the change of ocular microbiomes in this devastating disease. Several studies reported alteration of the ocular microbiomes in SJS patients, compared to healthy subjects. In healthy eyes, the most common microorganisms are Staphylococcus coagulase negative, Corynebacterium, and Propionibacterium 4,5 which are mainly gram-positive bacteria colonized in the ocular surface. In SJS, more pathogenic species are found including gram-negative bacteria. Frizon, et al. reported different compositions of microorganisms in SJS patients consisting of 55% of gram-positive cocci, 19% of gram-positive bacilli, and 25% of gram-negative bacilli 4 . They also found that these pathogenic organisms showed...

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“…This incidence correlated with the prevalence of contact lens wear and high gross national income [30]. On the contrary, in developing countries, the proportions of infectious keratitis attributable to bacteria were less [31][32][33] than or similar to those from fungus [34]. The Asia Cornea Society Infectious Keratitis Study (ACSIKS) group that included data from 13 study centers and 30 subcenters from 6626 eyes of 6563 subjects demonstrated the similar percentage of bacterial and fungal infections.…”

Section: Global Etiologiesmentioning

confidence: 99%

Infectious Keratitis: The Great Enemy

Roongpoovapatr¹,

Prabhasawat²,

Isipradit³

et al. 2020

Visual Impairment and Blindness - What We Know and What We Have to Know

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Infectious keratitis tops the list of diseases leading to visual impairment and corneal blindness. Corneal opacities, predominantly caused by infectious keratitis, are the fourth leading cause of blindness globally. In the developed countries, infectious keratitis is usually associated with contact lens wear, but in developing countries, it is commonly caused by trauma during agricultural work. The common causative organisms are bacteria, fungus, Acanthamoeba, and virus. Severe cases can progress rapidly and cause visual impairment or blindness that requires corneal transplantation, evisceration, or enucleation. The precise clinical diagnosis, accurate diagnostic tools, and timely appropriate management are important to reduce the morbidity associated with infectious keratitis. Despite the advancement of diagnostic tools and antimicrobial drugs, outcomes remain poor secondary to corneal melting, scarring, or perforation. Eye care strategies should focus on corneal ulcer prevention. This review addresses the epidemiology, diagnostic approach, clinical manifestations, risk factors, investigations, treatments, and the update of major clinical trials about common pathogens of infectious keratitis.

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The Asia Cornea Society Infectious Keratitis Study: A Prospective Multicenter Study of Infectious Keratitis in Asia

Cited by 167 publications

References 28 publications

Comparison of fungal and bacterial keratitis between tropical and subtropical Taiwan: a prospective cohort study

Comparison of fungal and bacterial keratitis between tropical and subtropical Taiwan: a prospective cohort study

Comparison of the ocular microbiome between chronic Stevens-Johnson syndrome patients and healthy subjects

Infectious Keratitis: The Great Enemy

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