Clinical Characteristics and Outcomes of Fungal Keratitis in the United Kingdom 2011-2020: A 10-Year Study
| Autor: | Mohamed Elalfy, Samer Hamada, Darren Shu Jeng Ting, Dalia G Said, Harminder S Dua, Damian Lake, Mohamed Galal, Bina Kulkarni |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Microbiology (medical)
medicine.medical_specialty Complete data Corneal Infection infectious keratitis QH301-705.5 contact lens Plant Science keratoplasty Infectious Keratitis Logistic regression Article Fusarium Internal medicine medicine Fungal keratitis Biology (General) Ecology Evolution Behavior and Systematics Candida business.industry fungal infection Corneal perforation medicine.disease corneal ulcer corneal infection Contact lens ophthalmology Candida spp business |
| Zdroj: | Journal of Fungi Volume 7 Issue 11 Journal of Fungi, Vol 7, Iss 966, p 966 (2021) |
| ISSN: | 2309-608X |
| Popis: | Fungal keratitis (FK) is a serious ocular infection that often poses significant diagnostic and therapeutic dilemmas. This study aimed to examine the causes, clinical characteristics, outcomes, and prognostic factors of FK in the UK. All culture-positive and culture-negative presumed FK (with complete data) that presented to Queen’s Medical Centre, Nottingham, and the Queen Victoria Hospital, East Grinstead, between 2011 and 2020 were included. We included 117 patients (n = 117 eyes) with FK in this study. The mean age was 59.0 ± 19.6 years (range, 4–92 years) and 51.3% of patients were female. Fifty-three fungal isolates were identified from 52 (44.4%) culture-positive cases, with Candida spp. (33, 62.3%), Fusarium spp. (9, 17.0%), and Aspergillus spp. (5, 9.4%) being the most common organisms. Ocular surface disease (60, 51.3%), prior corneal surgery (44, 37.6%), and systemic immunosuppression (42, 35.9%) were the three most common risk factors. Hospitalisation for intensive treatment was required for 95 (81.2%) patients, with a duration of 18.9 ± 16.3 days. Sixty-six (56.4%) patients required additional surgical interventions for eradicating the infection. Emergency therapeutic/tectonic keratoplasty was performed in 29 (24.8%) cases, though 13 (44.8%) of them failed at final follow-up. The final corrected-distance-visual-acuity (CDVA) was 1.67 ± 1.08 logMAR. Multivariable logistic regression analyses demonstrated increased age, large infiltrate size (> 3 mm), and poor presenting CDVA (< 1.0 logMAR) as significant negative predictive factors for poor visual outcome (CDVA of < 1.0 logMAR) and poor corneal healing (> 60 days of healing time or occurrence of corneal perforation requiring emergency keratoplasty all p < 0.05). In conclusion, FK represents a difficult-to-treat ocular infection that often results in poor visual outcomes, with a high need for surgical interventions. Innovative treatment strategies are urgently required to tackle this unmet need. |
| Databáze: | OpenAIRE |
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