Etiology-of-Infectious-Corneal-Ulcers-and-Bacteria.ppt

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1、Comparison of Bacterial Etiology of Infectious Corneal Ulcers in Contact Lens Wearers and Non-Contact Lens Wearers at the University of ChicagoShuchi B.Patel MD1,Krishna Patel1,Michael A.Saidel MD1 1Division of Ophthalmology and Visual Science,University of Chicago,Chicago,ILAuthors have no financia

2、l interestsPurpose We analyzed the laboratory results of corneal ulcers seen at University of Chicago between 2002 and 2007 in order to determine the relative frequencies of pathogens causing bacterial ulcers in both contact lens related and non-contact lens related.The results were then divided int

3、o two subgroups(contact lens associated,and non-contact lens associated).The bacterial spectrum was compared as well as the antibiotic susceptibilities.Methods A retrospective chart review was done for all patients identified as having a corneal ulcer between the years 2002 and 2007.Only patients wi

4、th central corneal ulcers were included in the study.Patients with viral,fungal,protozoan or neurotrophic ulcers were excluded(eg.bacterial ulcers only).Cultures Technique Taken with Kimura spatula With or without anesthesia Streaked on blood,chocolate,and Sabourad dextrose agar Lowenstien-Jensen,th

5、ioglycolate,nonnutrient agar with E.Coli overlay used if appropriate Sent for Gram and Giemsa stain Considered a positive culture If at least one colony was seen on two or more media Or if a colony was present on a single medium and the organism was also identified on stainingMost common organisms1.

6、1.Coagulase negative Coagulase negative staphylococcus(14/51)staphylococcus(14/51)2.2.Psuedomonas Psuedomonas aeruginosa(9/51)aeruginosa(9/51)3.3.Staphylococcus aureus Staphylococcus aureus(9/51)(9/51)4.4.aa hemolytic streptococci hemolytic streptococci(6/51)(6/51)5.5.Corynebacterium(5/51)Corynebact

7、erium(5/51).5 most common organisms in non-contact lens wearers1.Staphylococcus aureus Staphylococcus aureus(9/32)(9/32)2.aa hemolytic hemolytic streptococci(5/32)streptococci(5/32)3.Coagulase negative Coagulase negative staphylococcus(4/32)staphylococcus(4/32)4.Psuedomonas Psuedomonas aeruginosa(4/

8、32)aeruginosa(4/32)5.Corynebacterium 5.Corynebacterium(4/32)(4/32)6 most common organisms in contact lens wearers 1.Coagulase negative Coagulase negative staphylococcus(10/19)staphylococcus(10/19)2.Psuedomonas Psuedomonas aeruginosa(5/19)aeruginosa(5/19)3.Moraxella(1/19)4.Serratia(1/19)5.5.aa hemoly

9、tic hemolytic streptococci(1/19)streptococci(1/19)6.Corynebacterium 6.Corynebacterium(1/19)(1/19)There is a different spectrum of bacteria found in ulcers that are found in contact lens wearers versus those in non contact lens wearers,though the antibiotic susceptibilities are similar.The overall ba

10、cterial spectrum found was similar in percentages to those from previous publications.However,in the subgroup analysis,the spectrum appears much different,with Staph aureus becoming the most common agent found.Also,contrary to previously published literature,the most common contact lens associated bacteria was not Psuedomonas aeruginosa but coagulase negative staph.Further studies should be done to determine whether this finding is a new trend,location specific,or due to confounding factors such as previous treatment with antibiotics prior to performance of a culture.