Microbial Keratitis in Corneal Transplants: A 12-Year Analysis

Benjamin Griffin,1 Andrew Walkden,1,2 Arthur Okonkwo,1,2 Leon Au,1,2 Arun Brahma,1,2 Fiona Carley1,2 1Manchester Royal Eye Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK; 2School of Medical Sciences, University of Man...

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Autores principales:	Griffin B, Walkden A, Okonkwo A, Au L, Brahma A, Carley F
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2020
Materias:	cornea transplant infection graft microbial keratitis Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/c0e8424472234aa5899faed316accb73
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spelling	oai:doaj.org-article:c0e8424472234aa5899faed316accb732021-12-02T12:31:39ZMicrobial Keratitis in Corneal Transplants: A 12-Year Analysis1177-5483https://doaj.org/article/c0e8424472234aa5899faed316accb732020-10-01T00:00:00Zhttps://www.dovepress.com/microbial-keratitis-in-corneal-transplants-a-12-year-analysis-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Benjamin Griffin,1 Andrew Walkden,1,2 Arthur Okonkwo,1,2 Leon Au,1,2 Arun Brahma,1,2 Fiona Carley1,2 1Manchester Royal Eye Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK; 2School of Medical Sciences, University of Manchester, Manchester, UKCorrespondence: Andrew WalkdenManchester Royal Eye Hospital, Oxford Road, M13 9WL Tel +44 7792153269Email walkdenandrew@gmail.comPurpose: To investigate the frequencies, trends, and in vitro drug susceptibilities of the causative pathogens in corneal transplant microbial infections in Manchester Royal Eye Hospital.Methods: Corneal scrape results recorded by the microbiology service between 2004 and 2015 were extracted from an established database. This microbiological data was matched with a separate database of all corneal transplant procedures performed in our centre over this time period. Patient records were examined to collect specific patient data and to confirm the diagnosis of microbial keratitis.Results: A total of 1508 grafts had been performed at our centre in this period. 72 episodes of graft microbial keratitis were identified from 66 eyes that had undergone keratoplasty procedures. Mean age was 56, and 51% of subjects were male. Ninety-three percent of microbial keratitis episodes occurred in penetrating keratoplasty procedures and 6% in deep anterior lamellar keratoplasty procedures. No endothelial grafts presented with infections throughout this time period. Of the 79 organisms identified, 73% were gram positive, 23% gram negative and 4% fungi. With regard to gram-positive organisms, vancomycin and gentamicin showed 100% and 91% susceptibility, respectively. Ofloxacin had a resistance rate of 13.7%. In terms of gram-negative organisms, gentamicin and chloramphenicol showed 100% sensitivity, with cefuroxime showing 69%. Resistance rates were less than 15% in all tested gram-negative antimicrobials.Conclusion: This paper describes the largest collection of corneal transplant infections identified within the UK. This finding may aid clinicians in predicting possible causative organisms for microbial keratitis and aid antibiotic choice.Keywords: cornea, transplant, infection, graft, microbial keratitisGriffin BWalkden AOkonkwo AAu LBrahma ACarley FDove Medical Pressarticlecorneatransplantinfectiongraftmicrobial keratitisOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 14, Pp 3591-3597 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	cornea transplant infection graft microbial keratitis Ophthalmology RE1-994
spellingShingle	cornea transplant infection graft microbial keratitis Ophthalmology RE1-994 Griffin B Walkden A Okonkwo A Au L Brahma A Carley F Microbial Keratitis in Corneal Transplants: A 12-Year Analysis
description	Benjamin Griffin,1 Andrew Walkden,1,2 Arthur Okonkwo,1,2 Leon Au,1,2 Arun Brahma,1,2 Fiona Carley1,2 1Manchester Royal Eye Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK; 2School of Medical Sciences, University of Manchester, Manchester, UKCorrespondence: Andrew WalkdenManchester Royal Eye Hospital, Oxford Road, M13 9WL Tel +44 7792153269Email walkdenandrew@gmail.comPurpose: To investigate the frequencies, trends, and in vitro drug susceptibilities of the causative pathogens in corneal transplant microbial infections in Manchester Royal Eye Hospital.Methods: Corneal scrape results recorded by the microbiology service between 2004 and 2015 were extracted from an established database. This microbiological data was matched with a separate database of all corneal transplant procedures performed in our centre over this time period. Patient records were examined to collect specific patient data and to confirm the diagnosis of microbial keratitis.Results: A total of 1508 grafts had been performed at our centre in this period. 72 episodes of graft microbial keratitis were identified from 66 eyes that had undergone keratoplasty procedures. Mean age was 56, and 51% of subjects were male. Ninety-three percent of microbial keratitis episodes occurred in penetrating keratoplasty procedures and 6% in deep anterior lamellar keratoplasty procedures. No endothelial grafts presented with infections throughout this time period. Of the 79 organisms identified, 73% were gram positive, 23% gram negative and 4% fungi. With regard to gram-positive organisms, vancomycin and gentamicin showed 100% and 91% susceptibility, respectively. Ofloxacin had a resistance rate of 13.7%. In terms of gram-negative organisms, gentamicin and chloramphenicol showed 100% sensitivity, with cefuroxime showing 69%. Resistance rates were less than 15% in all tested gram-negative antimicrobials.Conclusion: This paper describes the largest collection of corneal transplant infections identified within the UK. This finding may aid clinicians in predicting possible causative organisms for microbial keratitis and aid antibiotic choice.Keywords: cornea, transplant, infection, graft, microbial keratitis
format	article
author	Griffin B Walkden A Okonkwo A Au L Brahma A Carley F
author_facet	Griffin B Walkden A Okonkwo A Au L Brahma A Carley F
author_sort	Griffin B
title	Microbial Keratitis in Corneal Transplants: A 12-Year Analysis
title_short	Microbial Keratitis in Corneal Transplants: A 12-Year Analysis
title_full	Microbial Keratitis in Corneal Transplants: A 12-Year Analysis
title_fullStr	Microbial Keratitis in Corneal Transplants: A 12-Year Analysis
title_full_unstemmed	Microbial Keratitis in Corneal Transplants: A 12-Year Analysis
title_sort	microbial keratitis in corneal transplants: a 12-year analysis
publisher	Dove Medical Press
publishDate	2020
url	https://doaj.org/article/c0e8424472234aa5899faed316accb73
work_keys_str_mv	AT griffinb microbialkeratitisincornealtransplantsa12yearanalysis AT walkdena microbialkeratitisincornealtransplantsa12yearanalysis AT okonkwoa microbialkeratitisincornealtransplantsa12yearanalysis AT aul microbialkeratitisincornealtransplantsa12yearanalysis AT brahmaa microbialkeratitisincornealtransplantsa12yearanalysis AT carleyf microbialkeratitisincornealtransplantsa12yearanalysis
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Microbial Keratitis in Corneal Transplants: A 12-Year Analysis

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