12-Year Analysis Of The Microbiological Profile Of Infectious Keratitis (Ik) In An Irish Tertiary Hospital.
Published 2022 - 40th Congress of the ESCRS
Reference: PP14.17 | Type: Free paper | DOI: 10.82333/9ykm-ea98
Authors: Kealan McElhinney* 1 , James Donnolly 2 , Michael Prentice 2 , Eddie McCullagh 2 , Edward Ahern 1 , Sarah Moran 1 , Tom Flynn 1
1Ophthalmology,Cork University Hospital,Cork,Ireland, 2Microbiology,Cork University Hospital,Cork,Ireland
Purpose
To examine the frequencies and causative microorganisms of infectious keratitis (IK) in Cork University Hospital, Ireland.
Setting
Departments of Ophthalmology and Microbiology, Cork University Hospital, Ireland.
Methods
A retrospective review of all patients who were diagnosed with IK and underwent corneal scraping between February 2010 and January 2022 (a 12-year period) at Cork University Hospital, a tertiary referral centre in Ireland. Corneal scrape specimens were identified from an established database. Demographic factors and microbiological profiles of IK were analysed. Polymerase chain reaction (PCR) swab results (acanthamoeba, herpes simplex virus, varicella zoster virus) were not included in this study.
Results
Mean age was 52.0 ± 25.6. Of the 315 corneal scrape specimens identified for inclusion, 189 (60.0%) had positive culture results. Polymicrobial growth (caused by ≥2 different microorganisms) occurred in 48 cases (15.2%). In total, there were 198 isolates recorded, with 17 specimens (8.6%) reported as mixed growth of skin flora. The most commonly isolated microorganisms were Coagulase-negative Staphylococci (CoNS) (35.4%), Staphylococcus aureus (16.7%), Pseudomonas aeruginosa (12.1%), Streptococcus pneumoniae (8.1%), and Gram-negative bacilli (6.1%). Fungi were isolated in 4.0% of cases. 22 of 102 (21.6%) gram-stain results were positive and 15 of these were concordant with culture results.
Conclusions
Our results of 60.0% positive-culture rate (135/189 corneal scrape specimens) are slightly higher than what has been described in the literature in the UK. Furthermore, there was a higher proportion of polymicrobial results (15.2%), likely relating to a significant number of CoNS being isolated (35.4%). We plan to review the threshold for performing corneal scrapes and the technique for sample acquisition. Revised guidance will be disseminated within the ophthalmology department through quality improvement education and implementation of a standard operating procedure (SOP). Additionally, 12.1% of isolates were identified as Pseudomonas aeruginosa, a smaller than expected figure compared to UK literature that warrants further investigation.