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Multivariate analysis of childhood microbial keratitis in South India
Gurdeep Singh1, Manikandan Palanisamy, Bhaskar Madhavan
1Pediatric Ophthalmology, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Coimbatore, Tamil Nadu, India. micro@cbe.aravind.org
Insights
Infectious microbial keratitis in children is often caused by trauma with organic matter, with Pseudomonas aeruginosa being the most common pathogen. Prompt diagnosis and treatment are crucial to prevent vision loss.
Area of Science:
- Ophthalmology
- Microbiology
- Pediatrics
Background:
- Corneal infection is a leading cause of blindness globally.
- Pediatric microbial keratitis presents diagnostic and management challenges due to patient cooperation issues.
- This study investigates infectious microbial keratitis in children at a South Indian tertiary eye care center.
Purpose of the Study:
- To analyze the prevalence, microbiology, and outcomes of microbial keratitis in pediatric patients.
- To identify common causative organisms and predisposing factors in childhood infectious keratitis.
- To evaluate therapeutic strategies and visual outcomes in this age group.
Main Methods:
- Retrospective review of pediatric keratitis cases (age <=15 years) from February 1997 to January 2004.
- Inclusion of culture-proven non-viral keratitis cases.
- Analysis of clinical, microbiological, demographic, and treatment data.
Main Results:
- Out of 310 cornea clinic attendees, 97 (31.2%) had microbial keratitis.
- Corneal trauma with organic matter was the most frequent predisposing factor (69%).
- Bacterial pathogens (65.9%) were more common than fungal pathogens (38.1%); Pseudomonas aeruginosa was the most isolated organism.
Conclusions:
- Corneal trauma is the primary cause of infectious microbial keratitis in children.
- Pseudomonas aeruginosa is the most frequently identified pathogen.
- Early diagnosis and a robust management protocol are essential to prevent severe visual impairment.
Introduction:
Corneal infection is the most common cause of profound ocular morbidity leading to blindness worldwide. Corneal infection in children is difficult to diagnose and treat, as they are unwilling and sometimes unable to cooperate during active management. This study analyses the prevalence, microbiology, demography, therapeutic and visual outcome of infectious microbial keratitis in the paediatric age group seen at a tertiary eye care hospital in south India.
Materials And Methods:
A retrospective review of all cases presenting with keratitis to the ocular microbiology and cornea service at Aravind Eye Hospital, Coimbatore, from February 1997 to January 2004, was done to screen the patients for microbial keratitis. Their records were further analysed for clinical and microbiological details. Cases with culture-proven non-viral keratitis in children
Results:
Of the 310 patients who attended the cornea clinic, 97 (31.2%) patients were confirmed to be positive for microbial keratitis. 54.6% of cases were male. The most common predisposing cause of ulceration was trauma (69%) with organic matter. Pure bacterial cultures were obtained from 64 (65.9%) eyes, whereas pure fungal cultures were obtained from 37 (38.1%) eyes. Four (4.1%) eyes showed mixed growth.
Conclusion:
The most commonly isolated organism was Pseudomonas aeruginosa. The most common predisposing cause of infectious microbial keratitis was corneal trauma. Early stage of diagnosis and formulation of an uncompromising management protocol can prevent profound visual morbidity.
