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http://hdl.handle.net/1843/61741
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DC Field | Value | Language |
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dc.creator | Carolina Saliba de Freitas | pt_BR |
dc.creator | Marcelo Oliveira Mesquita | pt_BR |
dc.creator | Mayara Seyko Kaczorowski Sasaki | pt_BR |
dc.creator | Alice Zaidan Azevedo | pt_BR |
dc.creator | Artur Willian Caldeira Abreu Veloso | pt_BR |
dc.creator | Marco Antônio Guarino Tanure | pt_BR |
dc.creator | Daniel Vítor de Vasconcelos Santos | pt_BR |
dc.date.accessioned | 2023-12-05T20:34:48Z | - |
dc.date.available | 2023-12-05T20:34:48Z | - |
dc.date.issued | 2022 | - |
dc.citation.volume | 86 | pt_BR |
dc.citation.issue | 4 | pt_BR |
dc.citation.spage | 345 | pt_BR |
dc.citation.epage | 352 | pt_BR |
dc.identifier.doi | https://doi.org/10.5935/0004-2749.20230050 | pt_BR |
dc.identifier.issn | 0004-2749 | pt_BR |
dc.identifier.uri | http://hdl.handle.net/1843/61741 | - |
dc.description.abstract | Purpose: To investigate the antibiotic susceptibility as well as the clinical, epidemiological, and microbiological profiles of microbial keratitis. Methods: This was a longitudinal retrospective study, and we retrospectively reviewed medical and laboratory records from 2015 to 2019. Results: In total, 380 pathogens (321 bacteria and 59 fungi) were isolated from the corneas of 352 patients. Staphylococcus species (45%) were most abundant within the organisms that were isolated, followed by Pseudomonas (18.4%), fungi (15.5%), Streptococcus (7.9%), and Serratia species (3.2%). The isolated gram-positive bacteria were not resistant to amikacin or vancomycin, although 14.8% of the gram-positive isolates were resistant to ciprofloxacin (p<0.05). All the gram-negative isolates were susceptible to amikacin. Male patients represented 62.8% of the 129 cases with accessible clinical data. The mean age of the patients was 53.17 ± 21 years. The time to presentation (from onset of symptoms) was 14.9 ± 19.4 days (median: 7 days). Large ulcers (>5 mm in any dimension) were present in 49.6% (64 eyes) of the cases. The duration of treatment was 49 ± 45.9 days (median: 38 days). Direct ocular trauma was reported by 48 (37.2%) patients, and 15 patients (11.6%) reported using contact lenses. For 72 (55.8%) patients, topical treatment had been previously prescribed, and 16 (12.4%) patients reported using other classes of drugs. Hospitalizations were required for 79 (61.2%) patients, and in terms of major complications, 53 (41.1%) patients had corneal perforations. A total of 40 patients (31%) underwent tectonic penetrating keratoplasty, and 28 (21.7%) developed secondary glaucoma. A progression to endophthalmitis occurred in 8 (6.2%) patients, with 50% of those patients’ (3.1% of the total) endophthalmitis evolving to evisceration. The patients’ microbial keratitis was largely treated empirically, with 94 (72.9%) patients prescribed moxifloxacin and 56 (43.4%) prescribed ciprofloxacin before receiving their culture results. Conclusions: For the most part, our hospital treated patients with severe microbial keratitis. Despite identifying gram-positive bacteria in most of the isolates, we also frequently identified gram-negative rods and fungi. Our susceptibility results support prescribing a combination of vancomycin and amikacin as an effective empirical therapeutic regimen to treat microbial keratitis. | pt_BR |
dc.description.resumo | Objetivo: Investigar a susceptibilidade a antibióticos, o perfil clínico, epidemiológico e microbiológico das ceratites infecciosas. Métodos: Estudo retrospectivo longitudinal. Registros médicos e laboratoriais de 2015 a 2019 foram revisados retrospectivamente. Resultados: Trezentos e oitenta patógenos (321 bactérias e 59 fungos) foram isolados das córneas de 352 pacientes. As espécies de Staphylococcus foram os microorganismos mais isolados (45%), seguidos de Pseudomonas (18,4%), fungos (15,5%), Streptococcus (7,9%) e Serratia (3,2%). Não houve resistência das bactérias Gram-positivas à amicacina ou vancomicina, enquanto 14,8% isolados Gram-positivos foram resistentes à ciprofloxacina (p<0,05). Todos os organismos Gram-negativos eram suscetíveis à amicacina. Pacientes do sexo masculino representaram 62,8% de 129 casos com dados clínicos acessíveis. A média de idade foi 53,17 ± 21 anos. O tempo até a apresentação (desde o início dos sintomas) foi de 14,9 ± 19,4 dias (mediana: 7 dias). Úlceras grandes (>5mm em qualquer extensão) representaram 49,6% (64 olhos) dos casos. A duração do tratamento foi de 49 ± 45,9 dias (mediana: 38 dias). Trauma ocular direto foi relatado por 48 (37,2%) pacientes e uso de lentes de contato por 15 (11,6%) pacientes. Foi prescrito tratamento prévio para 72 (55.8%) pacientes. Outras classes de medicamentos foram prescritas para 16 (12.4%). Setenta e nove (61,2%) pacientes tiveram que ser hospitalizados. Como complicações maiores, 53 (41,1%) pacientes apresentaram perfuração corneana, 40 pacientes (31%) foram submetidos à ceratoplastia penetrante tectônica e 28 (21,7%) desenvolveram glaucoma secundário. Oito pacientes (6,2%) evoluíram para endoftalmite. O tratamento empírico da ceratite microbiana foi amplamente empregado, com 94 (72,9%) pacientes em uso de moxifloxacina e 56 (43,4%) em uso de ciprofloxacina antes do resultado da cultura. Conclusões: Nosso hospital tratou predominantemente de pacientes com úlceras microbianas graves. Embora bactérias Gram-positivas constituíssem a maioria dos isolados, bacilos e fungos Gram-negativos também foram frequentemente identificados nas ceratites microbianas. Os resultados de suscetibilidade sugerem a combinação de vancomicina e amicacina como um regime terapêutico empírico eficaz para essa condição grave com risco de perda visual permanente. | pt_BR |
dc.format.mimetype | pt_BR | |
dc.language | eng | pt_BR |
dc.publisher | Universidade Federal de Minas Gerais | pt_BR |
dc.publisher.country | Brasil | pt_BR |
dc.publisher.department | MED - DEPARTAMENTO DE OFTALMOLOGIA E OTORRINOLARINGOLOGIA | pt_BR |
dc.publisher.department | MEDICINA - FACULDADE DE MEDICINA | pt_BR |
dc.publisher.initials | UFMG | pt_BR |
dc.relation.ispartof | Arquivos Brasileiros de Oftalmologia | pt_BR |
dc.rights | Acesso Aberto | pt_BR |
dc.subject | Ceratite | pt_BR |
dc.subject | Infecções oculares bacterianas | pt_BR |
dc.subject | Antibacterianos | pt_BR |
dc.subject.other | Ceratite | pt_BR |
dc.subject.other | Infecções Oculares Bacterianas | pt_BR |
dc.subject.other | Antibacterianos | pt_BR |
dc.title | Trends in the epidemiological and microbiological profiles of infectious keratitis in southeastern Brazil | pt_BR |
dc.title.alternative | Perfil epidemiológico e microbiológico das ceratites infecciosas no sudeste do Brasil | pt_BR |
dc.type | Artigo de Periódico | pt_BR |
dc.url.externa | https://aboonline.org.br/details/6319/en-US/perfil-epidemiologico-e-microbiologico-das-ceratites-infecciosas-no-sudeste-do-brasil | pt_BR |
dc.identifier.orcid | https://orcid.org/0000-0001-7873-6569 | pt_BR |
dc.identifier.orcid | https://orcid.org/0000-0002-6747-2024 | pt_BR |
Appears in Collections: | Artigo de Periódico |
Files in This Item:
File | Description | Size | Format | |
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Trends in the epidemiological and microbiological profiles of infectious keratitis in southeastern Brazil.pdf | 158.36 kB | Adobe PDF | View/Open |
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