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. 2024 Aug 10;12(8):1637.
doi: 10.3390/microorganisms12081637.

Long-Term Prevalence of Fungal Keratitis at a Swiss Tertiary Eye Clinic

Anahita Bajka  1 , Sadiq Said  1 , Chantal Quiblier  2 , Bettina Schulthess  2 , Ilana Reinhold  3 , Daniel Barthelmes  1 , Sandrine Anne Zweifel  1 , Frank Blaser  1
Affiliations

Long-Term Prevalence of Fungal Keratitis at a Swiss Tertiary Eye Clinic

Anahita Bajka et al. Microorganisms. .

Abstract

Fungal keratitis is a rare yet severe infection of the cornea. Fungal species distribution depends on the climate and socioeconomic status and can show regional variation. This retrospective single-center study was conducted at a tertiary eye care center and the collaborating Institute of Medical Microbiology in Switzerland. On investigating all fungal-positive corneal scrapings and contact lens assessments of patients with keratitis from January 2012 to December 2023, 206 patients were identified, of which 113 (54.9%) were female. The median age was 38 (IQR 29.8, [18-93]), and 154 (74.8%) applied contact lenses. The most commonly found pathogen was Candida spp., followed by Fusarium spp. Molds were 1.8 times more common than yeasts. Linear regression showed no significant increase or decrease in the infection rate over time (p = 0.5). In addition, 10 patients (4.9%) were found to have coinfections with Acanthamoeba, 11 (5.3%) with HSV-1, none with HSV-2, and 4 (1.9%) with VZV. This study provides a long-term overview of fungal-positive corneal scrapings and contact lens specimens of patients with fungal keratitis. Based on our results, coinfections with Acanthamoeba, HSV, and VZV are frequent, especially in patients wearing contact lenses. Thus, wearing contact lenses may facilitate coinfection in fungal keratitis.

Keywords: Aspergillus; Candida; contact lenses; contamination; cornea; fungal culture; fungal keratitis; fungal ocular infections; molds; yeasts.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Slit-lamp photography of different patients with fungal keratitis, obtained by direct illumination or scleral scatter. The following fungi are shown: (A1,A2) Fusarium solani, (B1) Aspergillus fumigatus, (B2) Aspergillus flavus, (C1) Paecilomyces sp., (C2) Scedosporium sp., (D1) Candida albicans, and (D2) Candida lipolytica.
Figure 2
Figure 2
Yearly breakdown of all detected fungi. Each detected species is only counted one time per patient a year.
Figure 3
Figure 3
Overview of all detected fungi. Each detected species is only counted one time per patient a year.
See this image and copyright information in PMC

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