Incidence and clinical characteristics of enterococcus keratitis

To study the incidence, clinically relevant factors, and antibiotic sensitivity profile of cases of enterococcal keratitis presenting at the New York Eye and Ear Infirmary between January 1, 1996, and December 31, 2005.

The records of all corneal cultures submitted to the Microbiology Laboratory of the New York Eye and Ear Infirmary between January 1, 1996, and December 31, 2005, were reviewed. All cases that were positive for Enterococcus species were identified, and the corresponding patients' medical records were obtained and studied.

There were 15 cases of enterococcal keratitis identified during the study period, and all were E. faecalis species. The age of the patients ranged from 17 to 98 years (mean age, 57.5 years). Twelve of the patients were women. Two patients developed keratitis in existing corneal grafts. Two patients were on topical steroid medications, with 1 having an existing corneal graft. Fourteen of the 15 had abnormalities of the ocular surface or wore contact lenses. Eight (53%) of the patients were soft contact lens wearers. Only 1 case was directly attributable to trauma. Fourteen (93%) of the bacterial isolates were sensitive to vancomycin. One case had intermediate sensitivity. Eleven cases resolved with topical antibiotics, 3 cases required penetrating keratoplasty, and in 1 case, the outcome is unknown.

Enterococcus faecalis keratitis is associated with abnormalities of the corneal surface and contact lens wear. Most of the isolates were sensitive to vancomycin, although 1 was of intermediate sensitivity, the importance of which is not known.