Spectrum of Microbial Keratitis Encountered in the Tropics

Area of Science:

• Ophthalmology
• Infectious Diseases
• Microbiology

Background:

• Microbial keratitis is a significant cause of vision loss globally.
• Tropical climates present unique challenges for ocular health due to specific microbial profiles and environmental factors.

Purpose of the Study:

• To identify predisposing factors for microbial keratitis in Miri, Borneo.
• To characterize causative microorganisms and their antibiotic sensitivities.
• To evaluate treatment outcomes in a tropical setting.

Main Methods:

• Retrospective study of 221 microbial keratitis cases over 7 years (2010-2016).
• Analysis of demographic data, predisposing factors, and ocular surface conditions.
• Review of corneal scraping culture and sensitivity results, and treatment interventions.

Main Results:

• Trauma (49.3%) and improper contact lens use (29.1%) were primary predisposing factors.
• Pseudomonas aeruginosa was the most common bacterial isolate, sensitive to ceftazidime and gentamicin.
• Fungal keratitis incidence was noted to increase, potentially linked to local oil palm industries.

Conclusions:

• Trauma remains the leading cause of microbial keratitis, with occupational injuries being significant.
• The microbial profile aligns with expectations for tropical climates, including an increase in fungal keratitis.
• Culture and sensitivity testing are crucial, though a substantial portion of cases were culture-negative; antibiotic resistance rates were not elevated.