A Comparison of Culture Results and Visual Acuity in Contact Lens Related Microbial Keratitis.

Autor: Hart JN; Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, USA., Lu MC; Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, USA., Tracey BM; Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, USA., Miller KD; Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, USA., Lephart PR; Department of Pathology, University of Michigan, Ann Arbor, MI, USA., Mian SI; Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, USA., Woodward MA; Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, USA.; Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA.
Jazyk: angličtina
Zdroj: Current eye research [Curr Eye Res] 2024 Jan; Vol. 49 (1), pp. 39-45. Date of Electronic Publication: 2024 Jan 03.
DOI: 10.1080/02713683.2023.2269322
Abstrakt: Purpose: Evaluate the effect of corneal and contact lens-related (CLR) culture results on visual acuity (VA) in patients with microbial keratitis (MK).
Methods: MK patients with corneal and CLR cultures were identified in the University of Michigan electronic health record from August 2012 to April 2022. Test results were classified as laboratory-positive or laboratory-negative. Linear regression was used to examine trends of VA and associations between changes in VA (differences of VA at 90-day and baseline VA) and corneal and CLR culture results, after adjustment for baseline VA. One-sample t-tests were used to test if the slope estimates were different from zero.
Results: MK patients ( n  = 50) were on average 49 years old (standard deviation = 20.9), 56% female, and 90% White. Positive corneal and CLR cultures were reported in 60% and 64% of patients, respectively, and 38% reported both. The agreement rate between corneal and CLR culture results was 30% ( n  = 15/50). LogMAR VA improved over time in patients with positive corneal and CLR cultures (Estimate=-0.19 per 10-day increase, p  = 0.002), and in those with negative corneal and positive CLR cultures (Estimate= -0.17 per 10-day increase, p  = 0.004). Compared to patients with negative corneal and CLR cultures, there was a trend toward improvement in VA for patients with positive corneal and CLR cultures (Estimate=-0.68, p  = 0.068), and those with negative corneal and positive CLR cultures (Estimate= -0.74, p  = 0.059), after adjusting for baseline VA.
Conclusions: Positive CLR cultures are associated with significant improvement in VA over time. These additional cultures can provide guidance on appropriate antimicrobial selection, especially when corneal cultures are negative.
Databáze: MEDLINE
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