Infectious bacterial keratitis management in a Swedish region: Risk factors, treatment and time-to-resolution

Area of Science:

• Ophthalmology
• Infectious Diseases
• Microbiology

Background:

• Bacterial keratitis (BK) is a significant cause of vision loss.
• Understanding treatment patterns and outcomes is crucial for managing BK.
• Specialized cornea clinics play a vital role in treating complex BK cases.

Purpose of the Study:

• To analyze treatment strategies, time-to-resolution (TTR), and causes of bacterial keratitis (BK) in a Swedish hospital cornea clinic.
• To identify factors influencing the healing rate of BK infections.

Main Methods:

• Retrospective analysis of electronic health records from 2010-2019.
• Inclusion of culture-confirmed bacterial keratitis cases only.
• Time-to-resolution (TTR) calculated from sample collection to corneal healing; Cox regression used for factor analysis.

Main Results:

• Contact lens wear and severe eye conditions were primary causes of BK.
• Fluoroquinolones with aminoglycosides were common empirical treatments.
• Median TTR varied: 22 days for contact lens-related BK, 90 days for complex cases.
• Females, contact lens wearers, and Gram-positive infections showed faster healing.
• Delayed chloramphenicol use was associated with slower healing.

Conclusions:

• This study provides novel TTR estimates for bacterial keratitis.
• Age, sex, etiology, empirical treatment, and Gram staining impact BK TTR.
• Empirical treatment incorporating chloramphenicol may expedite healing.
• Findings support personalized management and prognosis for BK patients.