Citrobacter keratitis: predisposing factors and clinical characteristics

Area of Science:

• Ophthalmology
• Infectious Diseases
• Microbiology

Background:

• Citrobacter species are uncommon pathogens causing bacterial keratitis.
• Identifying predisposing factors and understanding clinical presentations are crucial for managing this severe ocular infection.

Purpose of the Study:

• To detail the predisposing factors, clinical manifestations, antibiotic susceptibility, and treatment strategies for Citrobacter-induced infectious keratitis.

Main Methods:

• A retrospective review of culture-proven Citrobacter keratitis cases was conducted over an 8-year period (January 2012 - September 2020).
• Data extracted included patient demographics, predisposing conditions, and clinical signs.

Main Results:

• Eighteen cases were identified, with a median patient age of 66. Predisposing factors included ocular surface disease (44%), previous corneal surgery (33%), and trauma (33%).
• Visual acuity was significantly impaired (light perception to counting fingers). Hypopyon was present in 72% of cases, and corneal thinning in 39%.
• High in vitro sensitivity to ceftazidime and aminoglycosides was observed. Treatment involved topical amikacin and cefazoline in most cases (72.2%), with 38.9% requiring tectonic surgery.

Conclusions:

• Citrobacter spp. represent a rare but serious cause of bacterial keratitis.
• Previous keratoplasty and ocular surface disease are significant risk factors.
• The prognosis is often poor, frequently necessitating surgical intervention for infection control.