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Bacterial keratitis in Christchurch, New Zealand, 1997–2001
Author(s) -
Hall Reece C,
McKellar Malcolm J
Publication year - 2004
Publication title -
clinical and experimental ophthalmology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.3
H-Index - 74
eISSN - 1442-9071
pISSN - 1442-6404
DOI - 10.1111/j.1442-9071.2004.00867.x
Subject(s) - ciprofloxacin , gram staining , moraxella , medicine , microbiology and biotechnology , keratitis , pseudomonas aeruginosa , chloramphenicol , antibiotics , biology , dermatology , bacteria , genetics
Purpose: To identify which organisms cause bacterial keratitis in a local community and to determine how patients with suspected bacterial keratitis should be initially treated. Methods: The results of all corneal scrapes performed in the ophthalmology department of Christchurch Hospital between 1997 and 2001 were reviewed. All samples were collected at the ‘bedside’ by a technician from the microbiology department and were processed immediately. Results: Eighty‐seven corneal scrapes were performed on 78 patients. There was a positive Gram stain in 43.7% (38/87) of scrapes. There was a positive culture in 58.6% (51/87) of scrapes. The commonest Gram‐positive organisms were coagulase negative Staphylococci (19.4%) and Corynebacterium spp. (16.1%). The commonest Gram‐negative organisms were Moraxella spp. (19.4%) and Pseudomonas aeruginosa (3.2%). Every Gram‐positive organism was sensitive to chloramphenicol and every Gram‐negative organism was sensitive to ciprofloxacin. In contrast, 89% of Gram‐negative organisms were sensitive to chloramphenicol and 88% of Gram‐positive organisms were sensitive to ciprofloxacin. Conclusion: The results are very different to those reported by other centres. Most notably, a much higher incidence of infection by Corynebacterium spp. and Moraxella spp. and a lower incidence of Pseudomonas aeruginosa was found . In this centre it appears appropriate to initially treat patients with Gram‐positive organisms with chloramphenicol and patients with Gram‐negative organisms with ciprofloxacin. Patients with a negative Gram stain should be treated with alternating chloramphenicol and ciprofloxacin while awaiting culture results.