(精选)Etiology of Infectious Corneal Ulcers and Bacterial Susceptibility to ...一教学课件.pptVIP

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(精选)Etiology of Infectious Corneal Ulcers and Bacterial Susceptibility to ...一教学课件.ppt

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Comparison of Rates of Positive Cultures in Patients with Bacterial Keratitis With and Without Previous Empiric Treatment Krishna Patel1, Shuchi B. Patel MD1, Michael A. Saidel MD1 1Division of Ophthalmology and Visual Science, University of Chicago, Chicago, IL Authors have no financial interests Purpose To analyze the rates of positive cultures at our institution and to compare the rates of positive cultures from patients on no previous treatments versus those on empiric antibiotic treatment prior to obtaining a culture specimen. Methods A retrospective chart review was done for all patients identified as having a corneal ulcer between the years 2002 and 2007. Only patients with central corneal ulcers were included in the study. Patients with viral, fungal, protozoan or neurotrophic ulcers were excluded. Whether the patient was treatment naive or had already begun treatment prior to acquisition of a culture sample was noted. The rate of positive cultures in these subgroups was then analyzed. Cultures Technique Taken with Kimura spatula With or without anesthesia Streaked on blood, chocolate, and Sabourad dextrose agar Lowenstien-Jensen, thioglycolate, nonnutrient agar with E. Coli overlay used if appropriate Sent for Gram and Giemsa stain Considered a positive culture If at least one colony was seen on two or more media Or if a colony was present on a single medium and the organism was also identified on staining. Results 251 charts reviewed. 62 ulcers were included in the study. 53 of 62 ulcers were cultured (85%). 3 of the 9 ulcers not cultured were on previous antibiotics(33%). 19 of the 62 ulcers were on previous treatment (30%). 16 of the 53 cultured ulcers were on previous treatment(30%). 9 of the cultures on previous treatments were negative (56%) 7 of the cultures on previous treatments were positive(44%). Positive cultures on previous treatment Moxifloxacin- Grew Coagulase negative staphylococcus Ciprofloxacin- Grew Coagulase negati