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Abstract
Purpose
To investigate the predisposing factors, clinical manifestations, treatment results and risk factors for treatment failure in Staphylococcus epidermidis keratitis.
Methods
Sixty-one eyes of 61 patients who were diagnosed with Staphylococcus epidermidis keratitis were included in the present study. The past history, location and size of ulceration, hypopyon, treatment results, and antibiotic susceptibility were reviewed retrospectively. A logistic regression analysis was performed to identify the main prognostic risk factors for treatment failure.
Results
Twenty-six eyes (42.6%) had previous histories of corneal traumas. Polymicrobial infections were observed in 31 cases (50.8%), including 11 cases (35.5%) combined with the Fusarium species. Twenty-five eyes (41.0%) had lesions located at the corneal center. The average size of ulceration was 7.3 ± 7.2 mm2. Thirteen eyes (21.3%) with lesions that progressed or occurred in the corneal perforation underwent evisceration, penetrating keratoplasty or scleral graft. Risk factors for treatment failure were a history of previous keratitis (P = 0.003) and an ulcer exceeding 5.0 mm2 in size (P = 0.018).
References
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Figure 3.
(A) Anterior segment photograph of a 46-year-old woman, who had a history of corneal trauma at the first visit. Mild conjunctival injection and corneal infiltration were observed. The lesion was completely healed in 2 weeks with antimicrobial therapy. (B) Anterior segment photograph of an 89-year-old woman, who had a history of keratitis at a first visit. Slit-lamp examination revealed severe conjunctival injection, corneal lysis with a size of approximately 4 mm, hypopyon, corneal edema, folding of the Descemet's membrane. Staphylococcus epidermidis and Fusarium were isolated by corneal scraping. Despite of antimicrobial and antifungal therapy, patient's ocular condition deteriorated and evisceration was ultimately performed.
Figure 4.
Visual acuities of the eyes with Staphylococcus epidermidis keratitis in the first and last medical examinations.
Table 1.
Predisposing risk factors for Staphylococcus epidermidis keratitis
Table 2.
Antibiotic susceptibility pattern of Staphylococcus epidermidis
Table 3.
Clinical characteristics of 13 cases of Staphylococcus epidermidis keratitis with treatment failure
Table 4.
Comparison of patients characteristics between treatment success and treatment failure group
Table 5.
Prognostic factors for treatment failure in Staphylococcus epidermidis keratitis
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