ESCRS - PP20.01 - Epidemiology, Microbiology, And Outcomes Of Culture-Positive Bacterial Keratitis: The Kent Microbial Keratitis Study

Epidemiology, Microbiology, And Outcomes Of Culture-Positive Bacterial Keratitis: The Kent Microbial Keratitis Study

Published 2026 - 44th Congress of the ESCRS

Reference: PP20.01 | Type: Poster | DOI: 10.82333/n892-cr85

Authors: Mr Imran Karim Janmohamed* 1 , Dr Shuyi Teh 2 , Dr Oluwadamilola Oguntoye 1 , Ms Lanxing Fu 2 , Ms Chloe Robson 3 , Mr Mohamed Elalfy 4 , Ms Sundas Maqsood 1

1Ophthalmology Department,Maidstone and Tunbridge Wells NHS Trust,Maidstone,United Kingdom, 2Ophthalmology Department,East Kent Hospitals University NHS Foundation Trust,Canterbury,United Kingdom, 3Ophthalmology Department,East Kent Hospitals University NHS Foundation Trust,Maidstone,United Kingdom, 4Ophthalmology Department,Maidstone and Tunbridge Wells NHS Trust,Maidstone,United Kingdom;Corneaplastic Unit and Eye Bank, Queen Victoria Hospital NHS Foundation Trust,East Grinstead,United Kingdom;Cornea Unit,Research Institute of Ophthalmology,Giza,Egypt

Purpose

Bacterial keratitis (BK) is a significant cause of corneal blindness worldwide. This study presents the first comprehensive analysis of culture-positive BK in Kent.

Setting

Cornea Department, Maidstone and Tunbridge Wells NHS Trust

Methods

This retrospective observational study analysed culture-positive BK presenting to Maidstone and Tunbridge Wells NHS Trust and East Kent Hospitals University NHS Foundation Trust between January 2020 and December 2024. Clinical data were collected including risk factors, microbiological results, treatment regimens, and outcomes. Poor visual outcome was defined as best-corrected visual acuity < 6/24. Statistical analysis employed univariable and multivariable logistic regression to identify predictors of adverse outcomes.

Results

198 patients with culture-positive BK were identified with culture positivity rate of 40.1%. Predisposing factors were identified, with contact lens (CL)-wear predominating (51.0%. Gram-negative bacteria predominated (63.6%), with P aeruginosa representing 40.2% of isolates. CL-wear was significantly associated with P aeruginosa (84.2% of CL cases, p=0.001), whilst OSD, immunosuppression, topical steroid use, and prior corneal surgery were associated with gram-positive infections. Therapeutic keratoplasty was required in 15.2% of patients, with 48.1% achieving poor visual outcomes. Multivariable analysis identified epithelial defect size >3mm as the only independent predictor of poor visual outcomes (OR 3.87, 95% CI 1.68-9.26, p=0.002).

Conclusions

This study demonstrates evolving epidemiological patterns of BK in Kent, with gram-negative predominance, and CL-wear as the primary modifiable risk factor. Epithelial defect size emerged as the strongest predictor of poor visual outcome.