Pattern of Microbial Keratitis in Assiut University Hospital

Microbial keratitis (MK) is a potentially-serious, sight-threatening infection that may cause significant visual impairment or even blindness if not diagnosed and treated promptly.It can be caused by a range of pathogens including bacteria (Pseudomonas aeruginosa, Staphylococcus aureus, and Streptococcus pneumoniae), viruses(herpes viruses), parasites (e.g., Acanthamoeba), and fungi (yeasts, and filaments).

Bacterial keratitis (BK) is the most common cause of microbial keratitis Incidence, risk factors and impact of disease, vary widely according to region, access to health care, socioeconomic and environmental factors, predisposing conditions and causative organisms.The frequency and severity of keratitis are significantly higher in low-income countries.

The history of contact lens (CL) wear, ocular trauma, ocular surface disease (e.g. blepharitis, and dry eye), and systemic diseases (diabetes, and rheumatoid arthritis) are common risk factors associated with MK.

Early treatment reduces the risk of corneal scarring, vascularization, or perforation.Treatment with different anti-microbial agents depend on the presenting clinical picture, initiated with broad spectrum empirical antibiotics in suspected bacterial keratitis, prior to targeted treatment guided by corneal scraping for gram-stain, culture and sensitivity.

The diagnosis of MK is made on the clinical basis together with microbiological evaluation. The microbiological profile of microbial keratitis has shown great differences worldwide. Due to the continuous shifting in microbiological profile and antibiotics resistance profiles reported in several studies, microbiological investigations and antibiotic susceptibility are mandatory to provide an effective treatment.