根据培养阳性率比较分析与接触镜相关的细菌性角膜炎:25 年回顾性研究

Sunggeun Son, Cheol-Won Moon, C. Cho, Sang-Bumm Lee
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摘要

目的:本研究调查了培养阳性(CP)接触镜相关细菌性角膜炎(CLBK)的微生物概况和临床特征,并与培养阴性(CN)病例进行了比较:我们对 1998 年 1 月至 2022 年 12 月期间住院的 142 名 CLBK 患者进行了回顾性分析。CP组和CN组分别有79只眼睛(100个分离物)和63只眼睛。我们调查了 CP 组的微生物概况,并比较了 CP 组和 CN 组的流行病学、诱发因素、临床特征和治疗效果。治疗效果不佳是指最终最佳矫正视力(BCVA)≤0.5、治疗后BCVA恶化或需要手术干预。我们通过两比例 Z 检验分析评估了整个队列中治疗效果不佳的风险因素:CP组中,革兰氏阴性菌占85%,常见分离菌为假单胞菌(27%)和沙雷氏菌(26%)。CP 组和 CN 组在平均年龄(27.0 岁对 33.8 岁,P = 0.009)和佩戴治疗性绷带隐形眼镜史(13.9% 对 28.6%,P = 0.031)方面存在明显差异。然而,CP 组和 CN 组在症状持续时间、之前使用局部抗生素、戴隐形眼镜睡觉、上皮缺损大小、眼睑下垂和治疗效果不佳方面没有明显差异。全组治疗效果不佳的显著风险因素包括深度浸润(Z = 2.88)、上皮愈合时间≥ 7 天(Z = 2.30)、初始 BCVA < 0.1(Z = 2.20)、过期使用隐形眼镜(Z = 2.10)和上皮缺损面积≥ 5 平方毫米(Z = 2.05):CP组和CN组的临床特征和治疗效果无明显差异。结论:CP 组和 CN 组的临床特征和治疗效果无明显差异,但两组患者的初始临床表现不佳和过期使用隐形眼镜与治疗效果不佳有关。J 韩国人
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Comparative Analysis of Contact Lens-related Bacterial Keratitis According to Culture Positivity: A 25-year Retrospective Study
Purpose: This study investigated the microbiological profile and clinical characteristics of culture positive (CP) contact lens-related bacterial keratitis (CLBK) and compared them to culture negative (CN) cases.Methods: We retrospectively analyzed 142 CLBK patients hospitalized between January 1998 and December 2022. The CP and CN groups consisted of 79 eyes (100 isolates) and 63 eyes, respectively. We investigated the microbiological profile in the CP group and compared the epidemiology, predisposing factors, clinical characteristics, and treatment outcomes between the CP and CN groups. Poor treatment outcomes were defined as a final best-corrected visual acuity (BCVA) ≤ 0.5, worsened BCVA after treatment, or the need for surgical intervention. We evaluated the risk factors for poor treatment outcomes in the entire cohort through two-proportional Z-test analysis.Results: In CP group, gram-negative bacteria accounted for 85%, and common isolates were Pseudomonas (27%) and Serratia (26%) species. There were significant differences in mean age (27.0 years vs. 33.8 years, p = 0.009) and a history of therapeutic bandage contact lens wear (13.9% vs. 28.6%, p = 0.031) between the CP and CN groups. However, there were no significant differences in symptom duration, prior use of topical antibiotics, sleeping with wearing CL, epithelial defect size, hypopyon, and poor treatment outcomes. Significant risk factors for poor treatment outcomes in the entire group included deep infiltration (Z = 2.88), epithelial healing time ≥ 7 days (Z = 2.30), initial BCVA < 0.1 (Z = 2.20), over date use of contact lens (Z = 2.10), and epithelial defect size ≥ 5 mm2 (Z = 2.05).Conclusions: There were no significant differences in clinical characteristics and treatment outcomes between the CP and CN groups. Poor initial clinical findings and over date use of contact lens were associated with poor treatment outcomes in both groups. J Korean
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