CONTACT LENS-ASSOCIATED MICROBIAL KERATITIS IN A REFERRAL HOSPITAL IN SAO PAULO, BRAZIL
Contact lens (CL) wear is one of the most important risk factors for microbial keratitis (MK). The etiological agents responsible for corneal infection vary according to geographical region, period of time, and year of study.
Corneal samples of clinally diagnosed MK patients (from January 1987 to December 2016) that were sent to the Laboratory of Ocular Microbiology, São Paulo Hospital were included in this study. Laboratory results for cultures positive for bacteria, fungi, and Acanthamoeba spp. were analyzed retrospectively. To ascertain if the number of patients with CL-associated MK (CLMK), a risk factor for microbial infection, changed over time, the analysis was divided into three decades: 1987–1996, 1997–2006, and 2007–2016. Information including patient gender, age, and type of organism isolated was compared among the time periods. Chi-square analysis was performed using SPSS software (ver. 20.0)
The corneal samples of 10.562 patients with a clinical diagnosis of MK were included in the study, of which 1.848 were related to the use of CLs. The results revealed that the frequency of CLMK increased over the last two decades analyzed. Overall, males comprised a higher proportion of the Non-CL-associated MK (NCLMK) group (60.3%) and females were more prevalent in the CLMK group (59.5%). Patients aged 19 to 40 years were more frequently observed in the CLMK group for all periods. Staphylococcus spp. was the most prevalent Gram-positive bacteria, while Pseudomonas spp. was the most frequent Gram-negative bacteria, in the MK groups. Among MK fungal cases, filamentous fungi was the most prevalent fungus over the entire study period, with Fusarium spp. being the most frequent in the NCLMK group. Acanthamoeba spp. and Pseudomonas spp. positive samples were significantly correlated with CLMK.
The highest prevalence of CLMK was seen among females aged 19 to 40 years. Pseudomonas spp. and Acanthamoeba spp. were significantly correlated to CLMK in this study.
Acanthamoeba spp., bacteria, contact lenses/adverse effects/microbiology, corneal ulcer, eye infections/microbiology, fungi
UNIFESP - Sao Paulo - Brasil
Jorge Agi, Michelle Lima Farah, Maria Cecilia Zorat Yu, Talita Rochetti, Denise Freitas, Ana Luisa Hofling-Lima