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Twelve-year analysis of microbial keratitis trends at a UK tertiary hospital
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PurposeTo investigate the frequencies, trends, and in vitro drug susceptibilities of the causative pathogens in microbial keratitis in Manchester Royal Eye Hospital.Patients and methodsCorneal scrape results recorded by the microbiology service between 2004 and 2015 were extracted from an established database. A total of 4229 corneal scrape specimens were identified from an established database. First-line antibiotic treatment in our centre during the study period was ofloxacin and second line was cefuroxime and gentamicin.ResultsMean age was 45.9±21.0. A total of 1379 samples (32.6%) were culture positive. One hundred forty-eight (10.7%) specimens cultured multiple organisms. Of the 1539 organisms identified, 63.3% were Gram-positive bacteria, 27.3% Gram-negative bacteria, 7.1% fungi, and 2.3% Acanthamoebae. A decreasing trend in Gram-positive isolates was found together with a stable trend in Gram negatives and an increasing trend in Acanthamoeba and fungi. There appeared to be a significant increasing trend of Moraxella infection (P=0.001). In all, 83.1 and 90.8% of Gram-positive and -negative isolates tested were susceptible to ofloxacin, respectively. Cefuroxime covered 86.6% of Gram-positive and 61.4% of Gram-negative isolates, whereas gentamicin covered 88.8 and 96.5% of Gram-positive and -negative isolates, respectively.ConclusionWe found a change in the type of Gram-negative organisms isolated over time, with the Moraxella species on the rise. Reassuringly, no significant increase in resistance was observed in vitro for any of the commonly used antibiotics. Ofloxacin remains a good first-line antibiotic treatment but duo-therapy does have broader coverage and should be considered in non-responsive cases.
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“However, a large retrospective survey conducted in the U.K between 2004 and 2015 showed a rise in the annual incidence of fungal keratitis as percentage of all cases of microbial keratitis from 5.2% in 2004 to 9.5% in 2015 [156].”
From Global and Multi-National Prevalence of Fungal Diseases-Estimate Precision (2017) · cites this paper as [156]
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Metadata
- Authors
- Tan, S. Z., Walkden, A., Au, L., Fullwood, C., Hamilton, A., Qamruddin, A., Armstrong, M., Brahma, A. K., & Carley, F.
- Affiliations
- Manchester Academic Health Science Centre (GB)
- University of Manchester (GB)
- Manchester Royal Infirmary (GB)
- Corresponding author
- Tan, S Z
- Venue
- Eye
- Published
- 2017-04-28
- Volume
- 31
- Issue
- 8
- Pages
- 1229-1236
- ISSN
- 0078-5334 (ISSN-L)
- 0950-222X
- 1476-5454
- PMC
- PMC5584503
- OpenAlex
- W2608322410
- Cited by
- 136
- References
- 35
- Citations by year
- 2026: 17 · 2025: 10 · 2024: 16 · 2023: 18 · 2022: 19 · 2021: 22 · 2020: 11 · 2019: 15 · 2018: 5 · 2017: 3
- FWCI
- 9.07
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Eye (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Research Explorer (The University of Manchester) (submittedVersion)
- Topics
- Health Sciences › Medicine › Ophthalmology › Ocular Infections and Treatments
- Health Sciences › Medicine › Ophthalmology › Corneal surgery and disorders
- Health Sciences › Medicine › Ophthalmology › Traumatic Ocular and Foreign Body Injuries
- Keywords
- infectious keratitis, temporal trends, Gram-positive bacteria, Gram-negative bacteria, fungal keratitis, Acanthamoeba keratitis, Moraxella, antibiotic susceptibility, ofloxacin, cefuroxime, gentamicin
- MeSH terms
- Acanthamoeba, Adult, Aged, Anti-Bacterial Agents, Corneal Ulcer, Female, Fungi, Gram-Negative Bacteria, Gram-Positive Bacteria, United Kingdom, Humans, Keratitis, Male, Microbial Sensitivity Tests, Middle Aged, Retrospective Studies, Eye Infections, Bacterial, Drug Resistance, Bacterial, Tertiary Care Centers
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