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Prognostic factors in Moraxella keratitis

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Session Details

Session Title: Presented Poster Session: Miscellaneous and Infections

Venue: Poster Village: Pod 3

First Author: : M.Wakefield UK

Co Author(s): :    L. Papaiounou   S. Koo   J. Prydal   V. Savant     

Abstract Details

Purpose:

Moraxella species are a rare causative pathogen of bacterial keratitis and the literature to date describes the usual occurrence in immunocompromised patients, such as chronic alcoholics, diabetics or elderly/debilitated patients. Local ocular predisposing factors may also play a role. Over the last 2 years there has been a 4-fold increase in the incidence of Moraxella keratitis at Leicester Royal Infirmary, UK.

Setting:

Ophthalmology and Microbiology Departments, Leicester Royal Infirmary, Leicester, UK

Methods:

A retrospective analysis of 23 of 24 patients with culture positive Moraxella keratitis over the last 2 years study is presented. The study population varied in terms of systemic and local risk factors, with only a minority of classical systemic associations. Three different species of Moraxella were identified by mass spectroscopy: M. lacunata, M. liquifaciens,and M. non-liquifaciens. Clinical outcome seemed to vary significantly between species.

Results:

M.lacunata (13/23) almost exclusively resolved without complication and good vision, except one late presentation in a debilitated patient, usually with antibiotic monotherapy. M. non-liquifaciens (8/23) presented with larger abscesses, caused perforation and healed slowly with visual morbidity. It frequently affected those with systemic frailty and ocular risk factors. M. liquifaciens was identified in 2 cases, with minimal ocular or systemic risk factors, but nevertheless perforated, one with a good outcome but the other requiring two tectonic grafts. Changing antibiotic therapy based on laboratory sensitivities improved the clinical course of two patients, but did not prevent perforation in a third.

Conclusions:

In summary, we have recorded an increase in the incidence of Moraxella keratitis at Leicester Royal Infirmary. Patients did not fit the classical picture of those at risk. Species identification may indicate those with a better prognosis, M. lacunata being the only one associated with milder disease, reduced risk of perforation and better visual outcomes.

Financial Disclosure:

NONE

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