Microbial Keratitis in Corneal Transplants: A 12-Year Analysis

Area of Science:

• Ophthalmology
• Microbiology
• Infectious Diseases

Background:

• Corneal transplantation is a common procedure to restore vision.
• Microbial keratitis is a serious complication following corneal grafts.
• Understanding infection patterns is crucial for effective treatment.

Purpose of the Study:

• To determine the frequency and trends of microbial keratitis after corneal transplantation.
• To analyze the in vitro drug susceptibility of isolated pathogens.
• To provide data for Manchester Royal Eye Hospital's clinical practice.

Main Methods:

• Retrospective analysis of corneal scrape results from 2004-2015.
• Matching microbiological data with corneal transplant records.
• Review of patient records to confirm microbial keratitis diagnoses.

Main Results:

• 72 episodes of microbial keratitis identified in 1508 corneal transplants.
• Most infections occurred in penetrating keratoplasty (93%).
• Gram-positive bacteria were predominant (73%), with high vancomycin (100%) and gentamicin (91%) susceptibility. Gentamicin (100%) and chloramphenicol (100%) were effective against gram-negative organisms.

Conclusions:

• This study represents the largest UK cohort of corneal transplant infections.
• Findings can help clinicians predict causative organisms and guide empirical antibiotic selection.
• Monitoring antimicrobial susceptibility is vital for managing post-keratoplasty infections.