Infective keratitis in Hong Kong

Abstract

PURPOSE: To report the prevalence of infective keratitis in Hong Kong over a 7-year period, and to study the pattern of antibiotic resistance among these cases. SETTING: Eye Clinic, Eye Institute, University of Hong Kong METHODS: A retrospective review. All medical records of patients undergoing corneal scrapping from 1/1/2004 to 31/8/2011, at the Eye Clinic of the Eye Institute, University of Hong Kong, were reviewed. Culture result and sensitivity were analyzed. RESULTS: Corneal scrapping was performed on 306 patients during the period reviewed. Among them, 131 were male (48.3%). Mean age was 39 years old (range 1 to 96). Culture was positive in 82 cases (26.8%). Among the culture positive cases, the three most common pathogens were coagulase negative staphylococcus (9.5%), Pseudomonas Aeruginosa (6.9%), and Staphylococcus Aureus (4.6%). Among all culture positive cases with pathogens identified, resistance was noted towards methicillin (85%), penicillin (78%), cefuroxime (48%), erythromycin (34%), ciprofloxacin (20%), tobramycin (18%), and amikacin (14%). Fortunately, all were sensitive to gentamicin (100%) and vancomycin (100%). CONCLUSIONS: Culture positive rate for infective keratitis in Hong Kong is compatible to that reported in the literature. Common causative pathogens and respective sensitivity reported. Common empirical antibiotics for infective keratitis as well as prophylaxis for post-cataract surgery antimicrobial coverage included ciprofloxacin, levofloxacin, and tobramycin. Gentamicin, although being a first-line agent, appeared to have a high sensitivity rate. In view of the resistant pattern, empirical antibiotic of choice should be amended.