[Serious bacterial keratitis: a retrospective clinical and microbiological study]

To define clinical and microbiological characteristics of patients with bacterial keratitis hospitalized in the Bordeaux University Hospital Department of Ophthalmology.

A retrospective study of patients presenting serious bacterial keratitis was conducted over 32 months. Clinical features (age, risk factors, description, and visual acuity), progression, and bacteriological characteristics were statistically analyzed.

Seventy-three patients were hospitalized from January 2000 to August 2003. The mean age was 43.6 years old. The mean delay for referral was 6 days. Risk factors were noted in 93.1% of cases: contact lens wear (50% of risk factors); keratopathy (25%); corneal trauma (8.8%); general disease (8.8%); and corneal surgery (7.3%). Bacteriological cultures of corneal smears isolated an organism in 57.7% of cases. Pseudomonas aeruginosa (29.2%) and coagulase-negative Staphylococcus (22.9%) were the most frequent species. Gram-negative bacilli and Gram-positive cocci were also present. Gram-negative bacilli were largely dominant when associated with contact lenses (59.3% of bacteria in contact lens-related keratitis). Visual outcome was significantly correlated with anterior chamber inflammation and initial poor visual acuity.

In this study, Gram-negative bacilli keratitis appeared to be clearly dominant in cases of contact lens wear. This fact is complementary to the increase in Gram-positive cocci in developed countries, even with contact lens wear.