Clinical Analysis of Bacterial Keratitis According to Culture Positivity

ABSTRACT

PURPOSE: The purpose of this study was to evaluate the clinical aspects of inpatients with bacterial keratitis according to culture positivity. METHODS: This was a retrospective review of 98 cases of inpatients with bacterial keratitis who were treated between January 2011 and December 2016 in Yeungnam University Hospital. Epidemiology, predisposing factors, clinical characteristics, and treatment outcomes were compared between culture positive (CP, 39 eyes) and culture negative (CN, 59 eyes) groups. Risk factors for poor clinical outcome were evaluated in the total cohort and analyzed using multivariate logistic regression. RESULTS: Pseudomonas spp. (31%) and Staphylococcus spp. (24%) were common in the CP group. There were no significant differences in previous ocular surface disease, contact lens wear, or hypopyon between the two groups. Epithelial defect size ≥5 mm² (51%31%, p = 0.04) and initial visual acuity <0.1 (Snellen) (51%31%, p = 0.04) were significantly higher in the CP group than in the CN group. Epithelial healing time ≥14 days (18%5%, p = 0.08) and poor clinical outcome (28%20%, p = 0.37) were more common in the CP group than in the CN group. Risk factors for poor clinical outcome were previous ocular surface disease (odds ratio [OR] = 11.29, 95% confidence interval [CI] = 2.01–63.41, p = 0.006) and previous ocular surgery (OR = 6.98, 95% CI = 1.51–32.20, p = 0.01). CONCLUSIONS: The CP group showed relatively worse initial clinical characteristics than the CN group. Treatment outcomes were slightly worse in the CP group than in the CN group; however, this difference was not statistically significant. Previous ocular surface disease and previous ocular surgery were associated with poor clinical outcome.