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. 2020 Nov 27;10(1):35.
doi: 10.1186/s12348-020-00227-x.

A ten-year report of microbial keratitis in pediatric population under five years in a tertiary eye center

Mohammad Soleimani  1 , Seyed Ali Tabatabaei  2 , S Saeed Mohammadi  2 , Niloufar Valipour  2 , Arash Mirzaei  2
Affiliations

A ten-year report of microbial keratitis in pediatric population under five years in a tertiary eye center

Mohammad Soleimani et al. J Ophthalmic Inflamm Infect. .

Abstract

Purpose: To report characteristics of microbial keratitis in pediatric patients under five years.

Methods: Patients with infectious keratitis under the age of 5 years were included in this retrospective cross-sectional study for ten years. All patients were admitted and corneal scraping was performed in 81 children. Fortified empiric antibiotic eye drops including cefazolin (50 mg/cc) and amikacin (20 mg/cc) were started and the antibiotic regimen was continued or changed according to culture results. In the case of fungal keratitis, topical voriconazole (10 mg/cc) or natamycin (50 mg/cc) and topical chloramphenicol (5 mg/cc) were started. A tectonic procedure was done when corneal thinning or perforation was present.

Results: Ninety-Three Patients between 1 to 60 months with a mean age of 33 ± 18 months old with corneal ulcer were included in the study. The most common risk factor was trauma (40.9%) followed by contact lens use (8.6%). Cultures were negative for microbial growth in 28 (30.1%) patients. The most common pathogens were S. epidermidis (10.8%) and P. aeruginosa (10.8%). Fluoroquinolone antibiotics (ciprofloxacin; 93.8% sensitivity) were the most potent antibiotic against bacterial pathogens. Forty-one patients underwent tectonic procedures, which the most common ones were cyanoacrylate glue 18.3% followed by keratoplasty 16.1%.

Conclusion: This study emphasizes the role of trauma as the primary cause and S. epidermidis as the most frequent microorganism in pediatric keratitis; according to antibiogram results and poor cooperation of patients under five years, monotherapy with fluoroquinolones could be a good regimen in small non-central lesions without thinning.

Keywords: 5 years; Children; Corneal ulcer; Keratitis; Ocular trauma; Pediatric.

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Conflict of interest statement

None.

Figures

Fig. 1
Fig. 1
An infant presented with corneal thinning and diffuse infiltration related to Pseudomonas aeruginosa keratitis due to nail trauma, the patient underwent amniotic membrane transplantation as a tectonic procedure, a shows full thickness corneal scar one month later. b shows clear optical graft four weeks after corneal transplantation
Fig. 2
Fig. 2
Bar graph illustrates different pathogens in pediatric keratitis
Fig. 3
Fig. 3
An infant with a S. epidermidis keratitis with a history of ichthyosis
See this image and copyright information in PMC

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